Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada; Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Graduation Program in Psychiatry, Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil.
Rev Psiquiatr Salud Ment (Engl Ed). 2021 Jan-Mar;14(1):16-26. doi: 10.1016/j.rpsm.2020.07.003. Epub 2020 Aug 29.
Healthy lifestyles are relevant to several diseases and to maintain individuals' mental health. Exposure to epidemics and confinement have been consistently associated with psychological consequences, but changes on lifestyle behaviours remain under-researched.
An online survey was conducted among the general population living in Spain during the COVID-19 home-isolation. In addition to demographic and clinical data, participants self-reported changes in seven lifestyle domains. The Short Multidimensional Inventory Lifestyle Evaluation was developed specifically to evaluate changes during the confinement (SMILE-C).
A total of 1254 individuals completed the survey over the first week of data collection. The internal consistency of the SMILE-C to assess lifestyles during confinement was shown (Cronbach's Alpha=0.747). Most participants reported substantial changes on outdoor time (93.6%) and physical activity (70.2%). Moreover, about one third of subjects reported significant changes on stress management, social support, and restorative sleep. Several demographic and clinical factors were associated to lifestyle scores. In the multivariate model, those independently associated with a healthier lifestyle included substantial changes on stress management (p<0.001), social support (p=0.001) and outdoor time (p<0.001), amongst others. In contrast, being an essential worker (p=0.001), worse self-rated health (p<0.001), a positive screening for depression/anxiety (p<0.001), and substantial changes on diet/nutrition (p<0.001) and sleep (p<0.001) were all associated with poorer lifestyles.
In this study, sizable proportions of participants reported meaningful changes in lifestyle behaviours during the COVID-19 pandemic in Spain. Moreover, the SMILE-C was sensitive to detect these changes and presented good initial psychometric properties. Further follow-up studies should collect relevant data to promote healthy lifestyles in pandemic times.
健康的生活方式与多种疾病有关，也有助于维持个人的心理健康。接触传染病和隔离一直与心理后果密切相关，但生活方式行为的变化仍研究不足。
在 COVID-19 居家隔离期间，我们对居住在西班牙的普通人群进行了一项在线调查。除了人口统计学和临床数据外，参与者还自我报告了七个生活方式领域的变化。专门开发了短多维生活方式评估量表来评估隔离期间的变化（SMILE-C）。
在数据收集的第一周内，共有 1254 人完成了调查。SMILE-C 评估隔离期间生活方式的内部一致性得到了验证（Cronbach's Alpha=0.747）。大多数参与者报告户外活动时间（93.6%）和身体活动（70.2%）大幅增加。此外，约三分之一的受试者报告在压力管理、社会支持和恢复性睡眠方面发生了重大变化。一些人口统计学和临床因素与生活方式评分相关。在多变量模型中，与更健康的生活方式相关的因素包括压力管理（p<0.001）、社会支持（p=0.001）和户外活动时间（p<0.001）的显著变化等。相比之下，从事必要工作（p=0.001）、自我评估健康状况较差（p<0.001）、抑郁/焦虑筛查阳性（p<0.001）、饮食/营养（p<0.001）和睡眠（p<0.001）的显著变化都与较差的生活方式相关。
在这项研究中，相当一部分参与者报告在西班牙 COVID-19 大流行期间生活方式行为发生了重大变化。此外，SMILE-C 能够敏感地检测到这些变化，并具有良好的初步心理测量特性。进一步的随访研究应收集相关数据，以在大流行期间促进健康的生活方式。
