Mental Health Research Unit, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
Front Public Health. 2023 Jun 12;11:1196404. doi: 10.3389/fpubh.2023.1196404. eCollection 2023.
During the COVID-19 pandemic, questions about both consequences and helpful strategies to maintain quality of life (QoL) have become increasingly important. Thus, the aim of this study was to investigate the distribution of coping factors during the COVID-19 pandemic, their associations with QoL and the moderating role of certain sociodemographic characteristics.
Analyses were based on cross-sectional self-reports from German adult participants ( = 2,137, 18-84 years, 52.1% female) of the CORONA HEALTH APP Study from July 2020 to July 2021. Multivariate regression analyses were used to predict (a) coping factors assessed with the Brief COPE and (b) QoL assessed with the WHOQOL-BREF while taking measurement time, central sociodemographic, and health characteristics into account.
During the COVID-19 pandemic, German adults mostly pursued problem- and meaning-focused coping factors and showed a relatively good QoL [Mean values (M) from 57.2 to 73.6, standard deviations (SD) = 16.3-22.6], except for the social domain (M = 57.2, SD = 22.6), and with a decreasing trend over time (β from -0.06 to -0.11, < 0.01). Whereas, escape-avoidance coping was negatively related to all QoL domains (β = -0.35, < 0.001 for psychological, β = -0.22, < 0.001 for physical, β = -0.13, = 0.045 for social, β = -0.49, < 0.001 for environmental QoL), support- and meaning-focused coping showed positive associations with various QoL domains (β from 0.19 to 0.45, < 0.01). The results also suggested differences in the pursuit of coping factors as well as in the strength of associations with QoL by sociodemographic characteristics. Escape-avoidance-focused coping was negatively associated with QoL levels in older and less educated adults (simple slopes differed at < 0.001), in particular.
The results demonstrated what types of coping may be helpful to avoid QoL deterioration (i.e., support- and meaning-focused coping) and provide implications for future universal or targeted health promotion (i.e., older or less educated adults who lack social or instrumental support) and preparedness in the face of unknown challenging societal situations similar to that of the COVID-19 pandemic. Cross-sectional trends of enhanced use of escape-avoidance-focused coping and QoL deterioration point toward a need for increased attention from public health and policy.
在 COVID-19 大流行期间，人们对生活质量（QoL）的后果和有益策略都产生了浓厚的兴趣。因此，本研究的目的是调查 COVID-19 大流行期间应对因素的分布情况，及其与 QoL 的关联，以及特定社会人口特征的调节作用。
本研究基于德国成人参与者（n = 2137，18-84 岁，52.1%女性）于 2020 年 7 月至 2021 年 7 月间在 CORONA HEALTH APP 研究中的横断面自我报告数据。采用多元回归分析预测（a）采用Brief COPE 评估的应对因素，（b）采用 WHOQOL-BREF 评估的 QoL，同时考虑测量时间、中心社会人口和健康特征。
在 COVID-19 大流行期间，德国成年人主要采用问题和意义导向的应对策略，且表现出相对较好的 QoL [均值（M）范围为 57.2-73.6，标准差（SD）为 16.3-22.6]，除社会领域（M = 57.2，SD = 22.6）外，其 QoL 水平随时间呈下降趋势（β 从 -0.06 到 -0.11， < 0.01）。而逃避应对与所有 QoL 领域均呈负相关（β = -0.35， < 0.001 用于心理，β = -0.22， < 0.001 用于身体，β = -0.13， = 0.045 用于社会，β = -0.49， < 0.001 用于环境 QoL），支持和意义导向的应对与多种 QoL 领域呈正相关（β 从 0.19 到 0.45， < 0.01）。结果还表明，社会人口特征不同，应对因素的追求以及与 QoL 的关联强度也不同。逃避应对与年龄较大和受教育程度较低的成年人的 QoL 水平呈负相关（简单斜率在 < 0.001 时存在差异）。
结果表明，哪些类型的应对可能有助于避免 QoL 下降（即支持和意义导向的应对），并为未来的普遍或有针对性的健康促进（即缺乏社会或工具支持的年龄较大或受教育程度较低的成年人）以及面对类似 COVID-19 大流行的未知挑战性社会情况提供准备提供了启示。逃避应对的使用增加和 QoL 下降的横断面趋势表明，公共卫生和政策需要给予更多关注。
