Two Years After the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms
,
Abstract
Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM–) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs.
Method: In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM– (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses.
Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM–. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS.
Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.
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23. Wong MCS, Wong ELY, Huang J, Cheung AWL, Law K, Chong MKC, et al. Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine. 2021;39(7):1148-56.
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27. Woodruff A. COVID-19 Follow up Testing. J Infect. 2020;81(4):647-79.
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29. Zhang M, Li Q, Du X, Zuo D, Ding Y, Tan X, et al. Health Behavior Toward COVID-19: The Role of Demographic Factors, Knowledge, and Attitude Among Chinese College Students During the Quarantine Period. Asia Pac J Public Health. 2020;32(8):533-5.
30. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206-12.
31. Birimoglu Okuyan C, Begen MA. Working from home during the COVID-19 pandemic, its effects on health, and recommendations: The pandemic and beyond. PPC. 2022;58(1):173-9.
32. Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485-96.
33. Abramowitz JS, Deacon BJ. Psychometric properties and construct validity of the Obsessive-Compulsive Inventory--Revised: Replication and extension with a clinical sample. J Anxiety Disord. 2006;20(8):1016-35.
34. Huppert JD, Walther MR, Hajcak G, Yadin E, Foa EB, Simpson HB, et al. The OCI-R: validation of the subscales in a clinical sample. J Anxiety Disord. 2007;21(3):394-406.
35. Mohammadi A, Zamani R, Fata L. Validation of the Persian version of the obsessive-compulsive inventory-revised in a student sample. Psychol. Res. 2008;11(1-2):66-78.
36. Shahnazi H, Ahmadi-Livani M, Pahlavanzadeh B, Rajabi A, Hamrah MS, Charkazi A. Assessing preventive health behaviors from COVID-19: a cross sectional study with health belief model in Golestan Province, Northern of Iran. Infect Dis Poverty. 2020;9(1):157.
37. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q. 1988;15(2):175-83.
38. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.
39. Martin A, Rief W, Klaiberg A, Braehler E. Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006;28(1):71-7.
40. Farrahi H, Gharraee B, Oghabian MA, Zare R, Pirmoradi MR, Najibi SM, et al. The Study of Psychometric Properties of the Persian Version of the Patient Health Questionnaire-9 (PHQ-9) Among Students of Guilan University of Medical Sciences in the Academic Year 2017-18. IJPCP. 2020:0-.
41. Weiss DS. The impact of event scale: revised. Cross-cultural assessment of psychological trauma and PTSD: Springer; 2007. p. 219-38.
42. Beck JG, Grant DM, Read JP, Clapp JD, Coffey SF, Miller LM, et al. The impact of event scale-revised: psychometric properties in a sample of motor vehicle accident survivors. J Anxiety Disord. 2008;22(2):187-98.
43. Bienvenu OJ, Williams JB, Yang A, Hopkins RO, Needham DM. Posttraumatic stress disorder in survivors of acute lung injury: evaluating the Impact of Event Scale-Revised. Chest. 2013;144(1):24-31.
44. Panaghi L, Mogadam JA. Persian version validation in impact of event Scale-Revised. TUMJ TUMS Publications. 2006;64(3):52-60.
45. Stengler-Wenzke K, Beck M, Holzinger A, Angermeyer MC. [Stigma experiences of patients with obsessive compulsive disorders]. Fortschr Neurol Psychiatr. 2004;72(1):7-13.
46. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54(5):302-11.
47. Silva RM, Shavitt RG, Costa DL. Obsessive-compulsive disorder during the COVID-19 pandemic. Braz J Psychiatry. 2020;43(1):108.
48. Bahçecioğlu Turan G, Köse S, Aksoy M. Analysis of nursing students' obsessive and coping behaviors during the COVID-19 pandemic. PPC. 2021;57(4):1628-36.
49. Arnáez S, García-Soriano G, López-Santiago J, Belloch A. Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behav Cogn Psychother. 2020;48(3):315-26.
50. Acenowr CP, Coles ME. OCD during COVID-19: Understanding clinical and non-clinical anxiety in the community. Psychiatry Res. 2021;300:113910.
51. Cromer KR, Schmidt NB, Murphy DL. Do traumatic events influence the clinical expression of compulsive hoarding? Behav Res Ther. 2007;45(11):2581-92.
52. hassemzadeh H, Mojtabai R, Khamseh A, Ebrahimkhani N, Issazadegan AA, Saif-Nobakht Z. Symptoms of obsessive-compulsive disorder in a sample of Iranian patients. Int J Soc Psychiatry. 2002;48(1):20-8.
53. Loosen AM, Skvortsova V, Hauser TU. Obsessive-compulsive symptoms and information seeking during the Covid-19 pandemic. Transl Psychiatry. 2021;11(1):309.
54. Cox RC, Olatunji BO. Linking insomnia and OCD symptoms during the coronavirus pandemic: Examination of prospective associations. J Anxiety Disord. 2021;77:102341.
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56. Smail E, Schneider KE, DeLong SM, Willis K, Arrington-Sanders R, Yang C, et al. Health Beliefs and Preventive Behaviors Among Adults During the Early COVID-19 Pandemic in the United States: a Latent Class Analysis. Prev Sci. 2021;22(8):1013-22.
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2. Akbarpour S, Nakhostin-Ansari A, Sadeghniiat Haghighi K, Etesam F, Alemohammad ZB, Aghajani F, et al. COVID-19 Fear Association with Depression, Anxiety, and Insomnia: A National Web-Based Survey on the General Population. Iran J Psychiatry. 2022;17(1):24-34.
3. Pardamean E, Roan W, Iskandar KTA, Prayangga R, Hariyanto TI. Mortality from coronavirus disease 2019 (Covid-19) in patients with schizophrenia: A systematic review, meta-analysis and meta-regression. Gen Hosp Psychiatry. 2022;75:61-7.
4. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020;89:531-42.
5. Honein MA, Christie A, Rose DA, Brooks JT, Meaney-Delman D, Cohn A, et al. Summary of Guidance for Public Health Strategies to Address High Levels of Community Transmission of SARS-CoV-2 and Related Deaths, December 2020. MMWR Morb Mortal Wkly Rep. 2020;69(49):1860-1867.
6. Banerjee DD. The other side of COVID-19: Impact on obsessive compulsive disorder (OCD) and hoarding. Psychiatry Res. 2020;288:112966.
7. Samuels J, Holingue C, Nestadt PS, Bienvenu OJ, Phan P, Nestadt G. Contamination-related behaviors, obsessions, and compulsions during the COVID-19 pandemic in a United States population sample. J Psychiatr Res. 2021;138:155-62.
8. Khosravani V, Aardema F, Samimi Ardestani SM, Sharifi Bastan F. The impact of the coronavirus pandemic on specific symptom dimensions and severity in OCD: A comparison before and during COVID-19 in the context of stress responses. J Obsessive Compuls Relat Disord. 2021;29:100626.
9. Abba-Aji A, Li D, Hrabok M, Shalaby R, Gusnowski A, Vuong W, et al. COVID-19 Pandemic and Mental Health: Prevalence and Correlates of New-Onset Obsessive-Compulsive Symptoms in a Canadian Province. Int J Environ Res Public Health. 2020;17(19).
10. Zaccari V, D'Arienzo MC, Caiazzo T, Magno A, Amico G, Mancini F. Narrative Review of COVID-19 Impact on Obsessive-Compulsive Disorder in Child, Adolescent and Adult Clinical Populations. Front Psychiatry. 2021;12:673161.
11. Jelinek L, Moritz S, Miegel F, Voderholzer U. Obsessive-compulsive disorder during COVID-19: Turning a problem into an opportunity? J Anxiety Disord. 2021;77:102329.
12. Jelinek L, Voderholzer U, Moritz S, Carsten HP, Riesel A, Miegel F. When a nightmare comes true: Change in obsessive-compulsive disorder over the first months of the COVID-19 pandemic. J Anxiety Disord. 2021;84:102493.
13. Hubbard G, den Daas C, Johnston M, Dixon D. Sociodemographic and Psychological Risk Factors for Anxiety and Depression: Findings from the Covid-19 Health and Adherence Research in Scotland on Mental Health (CHARIS-MH) Cross-sectional Survey. Int J Behav Med. 2021;28(6):788-800.
14. Jose R, Narendran M, Bindu A, Beevi N, L M, Benny PV. Public perception and preparedness for the pandemic COVID 19: A Health Belief Model approach. Clin Epidemiol Glob Health. 2021;9:41-6.
15. Wong EL, Ho KF, Dong D, Cheung AW, Yau PS, Chan EY, et al. Compliance with Standard Precautions and Its Relationship with Views on Infection Control and Prevention Policy among Healthcare Workers during COVID-19 Pandemic. Int J Environ Res Public Health. 2021;18(7).
16. Jelinek L, Röhrig G, Moritz S, Göritz AS, Voderholzer U, Riesel A, et al. Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies. Br J Clin Psychol. 2022;61(3):816-35.
17. Cisler JM, Brady RE, Olatunji BO, Lohr JM. Disgust and Obsessive Beliefs in Contamination-related OCD. Cognit Ther Res. 2010;34(5):439-48.
18. Dai Y, Hu G, Xiong H, Qiu H, Yuan X. Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China. medrxiv. 2020:2020.03. 03.20030874.
19. Zhu Z, Xu S, Wang H, Liu Z, Wu J, Li G, et al. COVID-19 in Wuhan: Sociodemographic characteristics and hospital support measures associated with the immediate psychological impact on healthcare workers. EClinicalMedicine. 2020;24:100443.
20. Kisely S, Warren N, McMahon L, Dalais C, Henry I, Siskind D. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. Bmj. 2020;369:m1642.
21. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
22. Tsai FJ, Hu YJ, Chen CY, Tseng CC, Yeh GL, Cheng JF. Using the health belief model to explore nursing students' relationships between COVID-19 knowledge, health beliefs, cues to action, self-efficacy, and behavioral intention: A cross-sectional survey study. Medicine (Baltimore). 2021;100(11):e25210.
23. Wong MCS, Wong ELY, Huang J, Cheung AWL, Law K, Chong MKC, et al. Acceptance of the COVID-19 vaccine based on the health belief model: A population-based survey in Hong Kong. Vaccine. 2021;39(7):1148-56.
24. Wang X, Che Q, Ji X, Meng X, Zhang L, Jia R, et al. Correlation between lung infection severity and clinical laboratory indicators in patients with COVID-19: a cross-sectional study based on machine learning. BMC Infect Dis. 2021;21(1):192.
25. Asmundson GJG, Paluszek MM, Landry CA, Rachor GS, McKay D, Taylor S. Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? J Anxiety Disord. 2020;74:102271.
26. Quilty BJ, Clifford S, Hellewell J, Russell TW, Kucharski AJ, Flasche S, et al. Quarantine and testing strategies in contact tracing for SARS-CoV-2: a modelling study. Lancet Public Health. 2021;6(3):e175-e183.
27. Woodruff A. COVID-19 Follow up Testing. J Infect. 2020;81(4):647-79.
28. Knowles KA, Olatunji BO. Anxiety and safety behavior usage during the COVID-19 pandemic: The prospective role of contamination fear. J Anxiety Disord. 2021;77:102323.
29. Zhang M, Li Q, Du X, Zuo D, Ding Y, Tan X, et al. Health Behavior Toward COVID-19: The Role of Demographic Factors, Knowledge, and Attitude Among Chinese College Students During the Quarantine Period. Asia Pac J Public Health. 2020;32(8):533-5.
30. Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206-12.
31. Birimoglu Okuyan C, Begen MA. Working from home during the COVID-19 pandemic, its effects on health, and recommendations: The pandemic and beyond. PPC. 2022;58(1):173-9.
32. Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485-96.
33. Abramowitz JS, Deacon BJ. Psychometric properties and construct validity of the Obsessive-Compulsive Inventory--Revised: Replication and extension with a clinical sample. J Anxiety Disord. 2006;20(8):1016-35.
34. Huppert JD, Walther MR, Hajcak G, Yadin E, Foa EB, Simpson HB, et al. The OCI-R: validation of the subscales in a clinical sample. J Anxiety Disord. 2007;21(3):394-406.
35. Mohammadi A, Zamani R, Fata L. Validation of the Persian version of the obsessive-compulsive inventory-revised in a student sample. Psychol. Res. 2008;11(1-2):66-78.
36. Shahnazi H, Ahmadi-Livani M, Pahlavanzadeh B, Rajabi A, Hamrah MS, Charkazi A. Assessing preventive health behaviors from COVID-19: a cross sectional study with health belief model in Golestan Province, Northern of Iran. Infect Dis Poverty. 2020;9(1):157.
37. Rosenstock IM, Strecher VJ, Becker MH. Social learning theory and the Health Belief Model. Health Educ Q. 1988;15(2):175-83.
38. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13.
39. Martin A, Rief W, Klaiberg A, Braehler E. Validity of the Brief Patient Health Questionnaire Mood Scale (PHQ-9) in the general population. Gen Hosp Psychiatry. 2006;28(1):71-7.
40. Farrahi H, Gharraee B, Oghabian MA, Zare R, Pirmoradi MR, Najibi SM, et al. The Study of Psychometric Properties of the Persian Version of the Patient Health Questionnaire-9 (PHQ-9) Among Students of Guilan University of Medical Sciences in the Academic Year 2017-18. IJPCP. 2020:0-.
41. Weiss DS. The impact of event scale: revised. Cross-cultural assessment of psychological trauma and PTSD: Springer; 2007. p. 219-38.
42. Beck JG, Grant DM, Read JP, Clapp JD, Coffey SF, Miller LM, et al. The impact of event scale-revised: psychometric properties in a sample of motor vehicle accident survivors. J Anxiety Disord. 2008;22(2):187-98.
43. Bienvenu OJ, Williams JB, Yang A, Hopkins RO, Needham DM. Posttraumatic stress disorder in survivors of acute lung injury: evaluating the Impact of Event Scale-Revised. Chest. 2013;144(1):24-31.
44. Panaghi L, Mogadam JA. Persian version validation in impact of event Scale-Revised. TUMJ TUMS Publications. 2006;64(3):52-60.
45. Stengler-Wenzke K, Beck M, Holzinger A, Angermeyer MC. [Stigma experiences of patients with obsessive compulsive disorders]. Fortschr Neurol Psychiatr. 2004;72(1):7-13.
46. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatry. 2009;54(5):302-11.
47. Silva RM, Shavitt RG, Costa DL. Obsessive-compulsive disorder during the COVID-19 pandemic. Braz J Psychiatry. 2020;43(1):108.
48. Bahçecioğlu Turan G, Köse S, Aksoy M. Analysis of nursing students' obsessive and coping behaviors during the COVID-19 pandemic. PPC. 2021;57(4):1628-36.
49. Arnáez S, García-Soriano G, López-Santiago J, Belloch A. Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behav Cogn Psychother. 2020;48(3):315-26.
50. Acenowr CP, Coles ME. OCD during COVID-19: Understanding clinical and non-clinical anxiety in the community. Psychiatry Res. 2021;300:113910.
51. Cromer KR, Schmidt NB, Murphy DL. Do traumatic events influence the clinical expression of compulsive hoarding? Behav Res Ther. 2007;45(11):2581-92.
52. hassemzadeh H, Mojtabai R, Khamseh A, Ebrahimkhani N, Issazadegan AA, Saif-Nobakht Z. Symptoms of obsessive-compulsive disorder in a sample of Iranian patients. Int J Soc Psychiatry. 2002;48(1):20-8.
53. Loosen AM, Skvortsova V, Hauser TU. Obsessive-compulsive symptoms and information seeking during the Covid-19 pandemic. Transl Psychiatry. 2021;11(1):309.
54. Cox RC, Olatunji BO. Linking insomnia and OCD symptoms during the coronavirus pandemic: Examination of prospective associations. J Anxiety Disord. 2021;77:102341.
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| Files | ||
| Issue | Vol 18 No 4 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i4.13630 | |
| Keywords | ||
| COVID-19 Demographic Factors Family Health Belief Model Obsessive-Compulsive Disorder | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Salmani B, Hasani J, Zanjani Z, Gholami-Fesharaki M. Two Years After the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms. Iran J Psychiatry. 2023;18(4):429-442.
