COVID-19 effects on women's home and work life, family violence and mental health from the women's health expert panel of the American Academy of Nursing

The COVID-19 pandemic has had profound impact on the mental health of women across the lifespan. Compounded by role stress and for some women, family violence, direct pandemic-related fears have magnified stress and worries for women. Taylor S. Landry C.A. Paluszek M.M. Fergus T.A. McKay D. Asmundson G.J.G. COVID stress syndrome: Concept, structure, and correlates., Taylor S. Landry C.A. Paluszek M.M. Fergus T.A. McKay D. Asmundson G.J.G. Development and initial validation of the COVID stress scales., Taylor S. Landry C.A. Paluszek M.M. Rachor G.S. Asmundson G.J.G. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic., Taylor S. Landry C.A. Paluszek M.M. Rachor G.S. Asmundson G.J.G. Worry, avoidance, and coping during the COVID-19 pandemic: A comprehensive network analysis.) described a COVID stress syndrome, characterized by central worry about the dangers of COVID-19. Worries were associated with behaviors such as social avoidance, panic buying, and coping difficulties and with excessive worry, compulsive information checking, reassurance seeking, and high concern for protective gear. Those who believed COVID-19 dangers were exaggerated are thought to have disregard for preventive measures such as social distancing, hand hygiene, wearing masks, and vaccination; such disregard for preventive behaviors add to feelings of threat in women with high concern for COVID-19 dangers. Although women had higher total stress scores than men on the COVID stress scale, no other gender-specific analyses were evident. In an early 2020 poll using the Amazon Mechanical Turk platform (n = 1015, 54% women, average age 39 years), participants indicated exposure to and rated “stressfulness” for several COVID stressors over the past week, their coping strategies (including substance use, active coping, self-distraction, behavioral disengagement, humor), and their adherence to CDC guidelines. Rated more negatively by women than men were the stressors of risk of self or loved ones becoming infected; reading or hearing talk about severity and contagiousness of COVID; uncertainty regarding length of quarantine and/or social distancing. Women also rated more negatively: changes in daily personal routines (cooking, cleaning, exercise-relaxation, hobbies, attending work, earning money); changes in social routines (being with friends/loved ones); experiencing personal or religious ritual cancellations; and increased contact with close others causing conflict and co-worrying. They felt more negatively about needing to find the “silver lining”; losing current job opportunities that result in loss of training, education, or delay of graduation; changes to the national/global economy; and difficulty in accessing resources for daily life. Coping strategies reported by more women than men included distraction, seeking emotional social support, and religious support. Interestingly, women were more likely than men to want to adhere to CDC guidelines for social distancing, cleaning and handwashing, and engaging in person-to-person transmission protections (Park C.L. Russel B.S. Fendrich M. Finkelstein-Fox L. Hutchison M. Becker J. Amercans’ COVID-19 stress, coping, and adherence to CDC guidelines.). These observations, coupled with evidence that women make the majority of health care decisions for those close to them, make women the essential group to target for pandemic education and population-wide health programs, for example, vaccination adoption.Pandemic-related observations worldwide for women are heightened anxiety, anger, stress, agitation and withdrawal have heightened (), impairing overall mental health. In a study of the impact of COVID-19 on mental health of 1210 participants in China, female gender, student status, specific physical symptoms of myalgia, dizziness, coryza and poor self-rated health status were significantly associated with higher levels of stress, anxiety, and depression. Pandemic psychological impact was rated moderate or severe by 53.8%, 16.5% reported moderate to severe depressive symptoms, 28.8% moderate to severe anxiety symptoms, and 8.1% moderate to severe stress levels. (Wang J. Wang J.X. Yang G.S. The psychological impact of COVID-19 on Chinese individuals.). In the U.K. before the pandemic, about 10% of people reported anxiety-related disorders (Jia R. Ayhling K. Chalder T. Massey A. Broadbent E. Coupland C. Vedhara K. Mental health in the UK during the COVID-19 pandemic: Cross-sectional analyses from a community cohort study.) and associated lower quality of life with self-isolation (Anxiety, depression, and quality of life in primary care patients.). Shortly after the first case of COVID-19, a study with 932 adults over 18 years old (63.3% women) who were practicing self-isolation and social distancing, revealed that 36.8% reported poor mental health (judged by scores on the Beck Depression and Beck Anxiety Inventories and Edinburgh Mental Well-being Scale). Those with poor mental health were more likely to be women, younger, and single, separated, divorced, or widowed (Smith L. Jacob L. Yakkundi A. McDermott D. Armstrong N. Barnett Y. Lopez-Sanchez G.F. Martin S. Butler L. Tully M. Correlates of symptoms of anxiety and depression and mental wellbeing associated with COVID-18: A cross-sectional study of UK-based respondents.). In a large cohort from the UK, clinically significant levels of mental distress increased from 19% to 27% after lockdown occurred. Increases in General Health Questionnaire scores were greatest among 18–24-year-old and 25–34-year-old groups, women, and people living with young children, and those employed before the pandemic (Pierce M. Hope H. Ford T. Hatch S. Hotopf M. John A. Kontopantelis E. Webb R. Wessely S. McManus S Abel K.M. Mental health before and during the COVID-19 pandemic: A longitudinal probabnlility sample survey of the UK population.).

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