Factors related to preventive COVID-19 infection behaviors among people with mental illness

J Formos Med Assoc. 2020 Dec;119(12):1772-1780. doi: 10.1016/j.jfma.2020.07.032. Epub 2020 Jul 29.

Abstract

Background/purpose: Because of the spread of novel coronavirus disease 2019 (COVID-2019), preventive COVID-19 infection behaviors become important for individuals, especially those who are vulnerable. The present study proposes a model to explain the preventive COVID-19 infection behaviors among people with mental illness in Taiwan.

Methods: A cross-sectional design was carried out and 414 patients with mental illness (230 males [55.6%]; mean age = 46.32 [SD = 10.86]) agreed to participate in the study. All the participants completed the Preventive COVID-19 Infection Behaviors Scale, Self-Stigma Scale-Short, Believing COVID-19 Information Scale, Fear of COVID-19 Scale, and Depression Anxiety Stress Scale-21. Regression models and structural equation modeling (SEM) were applied to examine the factors associated with preventive COVID-19 infection behaviors.

Results: Both regression models and SEM showed that trust in COVID-19 information sources (standardized coefficient [β] = 0.211 in regression; β = 0.194 in SEM) and fear of COVID-19 (β = -0.128 in regression; β = -0.223 in SEM) significantly explained preventive behaviors among individuals with mental illness. The SEM further showed that fear of COVID-19 was significantly explained by trust in COVID-19 information sources (β = 0.220) and self-stigma (β = 0.454).

Conclusion: Based on the results, healthcare providers should help individuals with mental illness reduce self-stigma and fear of COVID-19 which would consequently improve their preventive COVID-19 infection behaviors. Moreover, improving trust in COVID-19 information sources for individuals with mental illness may be another method to improve their preventive behaviors.

Keywords: COVID-19; Fear; Preventive behavior; Psychological distress; Self-stigma.

MeSH terms

  • Adult
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Health Behavior*
  • Humans
  • Latent Class Analysis
  • Male
  • Mental Disorders / psychology*
  • Mental Disorders / virology
  • Middle Aged
  • Models, Psychological*
  • Pandemics / prevention & control*
  • Patient Acceptance of Health Care / psychology
  • Persons with Mental Disabilities / psychology*
  • Pneumonia, Viral / prevention & control*
  • Psychiatric Status Rating Scales
  • Regression Analysis
  • SARS-CoV-2
  • Social Stigma
  • Taiwan
  • Trust