COVID-19 pandemisinin huzurevinde yaşayan yaşlı bireylerde anksiyete, depresyon ve bilgiye erişim davranışları üzerindeki psikolojik etkileri

Abstract

Amaç: COVID-19 pandemisi, huzurevlerinde yaşayan yaşlı bireyler ve toplumun tüm kesimleri üzerinde önemli psikososyal etkiler yaratmıştır. Bu çalışma, pandemi öncesi ve sonrasında huzurevlerinde yaşayan yaşlı bireylerin anksiyete, depresyon, yaşam kalitesi ve bilgiye erişim alışkanlıklarını değerlendirmeyi amaçlamıştır. Yöntem: Bir huzurevinde yürütülen bu kesitsel çalışmada, katılımcıların psikolojik durumları pandemi öncesi ve sonrası olmak üzere iki farklı zamanda değerlendirilmiştir. Kullanılan ölçekler arasında Geriatrik Depresyon Ölçeği (GDS), Geriatrik Anksiyete Ölçeği (GAS), Olayların Etkisi Ölçeği (IES), Koronavirüs Anksiyete Ölçeği (CAS) ve EQ-5D yer almaktadır. Bulgular: Pandemi sonrasında GAS ve IES puanlarında anlamlı artışlar tespit edilmiş olup, bu durum anksiyete ve stres düzeylerinin arttığını göstermektedir. CAS puanlarında istatistiksel olarak anlamlı bir artış gözlemlenmesine rağmen, katılımcıların %75,34'ü COVID-19'a özgü sınırlı anksiyeteyi gösteren "0" puan almıştır. GDS ve EQ-5D puanlarında anlamlı bir değişiklik bulunmamıştır. Ek olarak, zamanla televizyon yerine personelden bilgi edinme eğilimiyle birlikte bilgi erişim kaynaklarında bir değişim gözlemlenmiştir. Sonuç: COVID-19 pandemisi, huzurevlerinde yaşayan yaşlı bireylerde genel anksiyete ve stres düzeylerini artırmış, ancak COVID-19'a özgü anksiyete sınırlı kalmıştır. Bulgular, anksiyetenin erken tanınmasının, psikososyal desteğin güçlendirilmesinin ve güvenilir bilgi paylaşımının sağlanmasının, kriz zamanlarında yaşlı bireylerde psikolojik dayanıklılığı artırmak için kritik öneme sahip olduğunu göstermektedir.

Keywords

• huzurevi
• geriatri
• Covid 19
• depresyon
• anksiyete

Psychological impact of the COVID-19 pandemic on anxiety, depression, and information-seeking behaviors among elderly residents of a nursing home

Abstract

Aims: This study explored how anxiety, depression, trauma-related stress, quality of life (QoL) and information-seeking habits changed among residents of a nursing home during the early months of the COVID-19 pandemic. The first evaluation was carried out at the very beginning of the pandemic, a time when no infections had yet been detected in the facility. The second assessment took place five months later, after the first confirmed case had occurred inside the nursing home. Methods: The same group of residents was assessed twice, following a repeated-measures comparative approach. This study was conducted in a municipal nursing home, and evaluations were performed at two distinct time points. The first assessment took place in March 2020, shortly after national restriction measures were introduced and before any COVID-19 cases had occurred within the facility. The second assessment was conducted in the following months after the first in-house transmission, reflecting the early progression of the pandemic within the institutional setting. Psychological status was measured using the Geriatric Depression Scale (GDS), Geriatric Anxiety Scale (GAS), Impact of Events Scale (IES), Coronavirus Anxiety Scale (CAS), and EQ-5D, all administered face-to-face to eligible participants. Results: Across the five-month interval, there was a marked rise in anxiety and trauma-related stress (GAS increased from 3 to 12, p<0.001; IES from 4 to 28, p<0.001). Depression levels did not show a meaningful change (p=0.655), and EQ-5D scores also remained relatively stable. Although one in four residents showed an increase in CAS scores (p=0.002), most participants (75.3%) continued to score “0,” suggesting very limited COVID-19-specific anxiety. A noticeable shift occurred in information seeking behavior as well: residents increasingly turned to staff members rather than relying solely on television (p=0.013). Conclusion: The psychological profile of nursing home residents changed considerably during the first half-year of the pandemic, particularly after the facility documented its first case. Approaches that offer emotional support and ensure clear, dependable communication may help strengthen the resilience of older adults in similar crises.

Keywords

• COVID-19
• elderly
• nursing home
• anxiety
• depression
• quality of life
• information-seeking

References

1. Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. doi:10. 1056/NEJMoa2001017
2. World Health Organisation. COVID-19 pandemic timeline. WHO, 2020.
3. Banerjee D. The impact of COVID-19 pandemic on elderly mental health. Asian J Psychiatr. 2020;51:102154. doi:10.1016/j.ajp.2020.102154
4. Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the COVID-19 pandemic among the elderly. Front Psychol. 2020;11:572738. doi:10.3389/fpsyg.2020.572738
5. Kilincel O, Muratdagi G, Aydin A, et al. The anxiety and loneliness levels of geriatric population in-home quarantine during COVID-19 pandemic in Turkey. Turkish J Clin Psychiatr. 2020;23(Suppl 1):7-14. doi: 10.5505/kpd.2020.04382
6. Santini ZI, Jose PE, York Cornwell E, et al. Social disconnectedness, perceived isolation, and symptoms of depression and anxiety among older Americans (NSHAP): a longitudinal mediation analysis. Lancet Public Health. 2020;5(1):e62-e70. doi:10.1016/S2468-2667(19)30230-0
7. D'cruz M, Banerjee D. 'An invisible human rights crisis': the marginalization of older adults during the COVID-19 pandemic. Asian J Psychiatr. 2020;54:102263. doi:10.1016/j.ajp.2020.102263
8. Ammar A, Brach M, Trabelsi K, et al. Effects of COVID-19 home confinement on eating behaviour and physical activity: results of the ECLB-COVID19 International Online Survey. Nutrients. 2020;12(6): 1583. doi:10.3390/nu12061583

9. Hwang TJ, Rabheru K, Peisah C, Reichman W, Ikeda M. Loneliness and social isolation during the COVID-19 pandemic. Int Psychogeriatr. 2020;32(10):1217-1220. doi:10.1017/S1041610220000988
10. Cugmas M, Ferligoj A, Kogovšek T. The effects of COVID-19 lockdown measures on elderly loneliness. Soc Sci Med. 2021;272:113712. doi:10. 1016/j.socscimed.2021.113712
11. Mueller AL, McNamara MS, Sinclair DA. Why does COVID-19 disproportionately affect older people? Aging (Albany NY). 2020;12(10): 9959-9981. doi:10.18632/aging.103344
12. Yanez ND, Weiss NS, Romand JA, Treggiari MM. COVID-19 mortality risk for older men and women. BMC Public Health. 2020;20(1):1742. doi: 10.1186/s12889-020-09826-8
13. Robb CE, de Jager CA, Ahmadi-Abhari S, et al. Associations of social isolation with anxiety and depression during the early COVID-19 pandemic: a survey of older adults in London, UK. Front Psychiatry. 2020;11:591120. doi:10.3389/fpsyt.2020.591120
14. Grolli RE. The impact of COVID-19 pandemic on mental health and cognitive functions in elderly populations. Brain Behav Immune. 2021; 89:230-238. doi:10.1016/j.bbi.2020.08.026
15. Kotwal AA, Holt-Lunstad J, Newmark RL, et al. Social isolation and loneliness among San Francisco Bay area older adults during the COVID-19 shelter-in-place orders. J Am Geriatr Soc. 2021;69(1):20-29. doi:10.1111/jgs.16865
16. Cavazzoni F, Pancake R, Veronese G. Impact of COVID-19 pandemic on mental health and quality of life. An exploratory study during the first outbreak in Italy. Psychol Rep. 2023;126(4):1661-1683. doi:10.1177/ 00332941211066259
17. Simard J, Volicer L. Loneliness and isolation in long-term care and the COVID-19 pandemic. J Am Med Dir Assoc. 2020;21(7):966-967. doi:10. 1016/j.jamda.2020.05.006
18. Gerritsen DL, Leontjevas R, Prins M, van der Roest H. De gevolgen van de COVID-19 maatregelen voor het welbevinden van bewoners van instellingen voor langdurige zorg [Consequences of the COVID-19 measures for wellbeing aspects of long-term care residents]. Tijdschr Gerontol Geriatr. 2022;53(1):1-14. doi:10.36613/tgg.1875-6832/2022.01.01
19. Van der Roest HG, Prins M, van der Velden C, et al. The impact of COVID-19 measures on well-being of older long-term care facility residents in the Netherlands. J Am Med Dir Assoc. 2020;21(11):1569-1570. doi:10.1016/j.jamda.2020.09.007
20. Yang S, Kwak SG, Chang MC. Psychological impact of COVID-19 on hospital workers in nursing care hospitals. Nurs Open. 2021;8(1):284-289. doi:10.1002/nop2.628
21. Kotwal AA, Cenzer IS, Waite LJ, et al. The epidemiology of social isolation and loneliness among older adults during the last years of life. J Am Geriatr Soc. 2021;69(11):3081-3091. doi:10.1111/jgs.17366
22. Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983;17(1):37-49. doi:10.1016/0022-3956(82)90033-4
23. Segal DL, June A, Payne M, Coolidge FL, Yochim B. Development and initial validation of a self-report assessment tool for anxiety among older adults: the Geriatric Anxiety Scale. J Anxiety Disord. 2010;24(7):709-714. doi:10.1016/j.janxdis.2010.05.002
24. Lee SA. Coronavirus Anxiety Scale: a brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401. doi:10.1080/ 07481187.2020.1748481
25. EuroQol Group. EuroQol--a new facility for the measurement of health-related QoL. Health Policy. 1990;16(3):199-208. doi:10.1016/0168-8510(90)90421-9
26. Horowitz M, Wilner N, Alvarez W. Impact of Event Scale: a measure of subjective stress. Psychosom Med. 1979;41(3):209-218. doi:10.1097/ 00006842-197905000-00004
27. Czeisler MÉ, Lane RI, Petrosky E, et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic-United States, June 24-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(32):1049-1057. doi:10.15585/mmwr.mm6932a1
28. Vahia IV, Blazer DG, Smith GS, et al. COVID-19, mental health and aging: a need for new knowledge to bridge science and service. Am J Geriatr Psychiatry. 2020;28(7):695-697. doi:10.1016/j.jagp.2020.03.007
29. Pfefferbaum B, North CS. Mental health and the COVID-19 pandemic. N Engl J Med. 2020;383:510-512. doi:10.1056/NEJMp2008017
30. Caycho-Rodríguez T, Vilca LW, Peña-Calero BN, Barboza-Palomino M, White M, Reyes-Bossio M. Measurement of coronaphobia in older adults: validation of the Spanish version of the Coronavirus Anxiety Scale. Rev Esp Geriatr Gerontol. 2022;57(1):20-27. doi:10.1016/j.regg. 2021.09.001
31. Gulpers B, Ramakers I, Hamel R, Köhler S, Oude Voshaar R, Verhey F. Anxiety as a predictor for cognitive decline and dementia: a systematic review and meta-analysis. Am J Geriatr Psychiatry. 2016;24(10):823-842. doi:10.1016/j.jagp.2016.05.015
32. Bonanno GA, Wortman CB. Grief and resilience in older adults during collective loss. Am Psychol. 2004;59(1):20-28. doi:10.1037/0003-066X.59.1.20