key: cord-1031547-b2rdpy50
authors: Li, Dian‐Jeng; Ko, Nai‐Ying; Chen, Yi‐Lung; Wang, Peng‐Wei; Chang, Yu‐Ping; Yen, Cheng‐Fang
title: Confidence in coping with COVID‐19 and its related factors among the public in Taiwan
date: 2020-08-12
journal: Psychiatry Clin Neurosci
DOI: 10.1111/pcn.13128
sha: c8b98679279f3e388b411b44f7a0dd7ca9b419fe
doc_id: 1031547
cord_uid: b2rdpy50

nan

Field to the manuscript: social psychiatry and epidemiology (primary); general topics in psychiatry and related fields (secondary) Confidence in coping with respiratory infection diseases (RID) has the influence on coping strategies that people may use during the pandemic. A study in Hong Kong demonstrated that elderly individuals who had greater confidence were more likely to adopt the authority-suggested preventive behaviors during the severe acute respiratory syndrome (SARS) pandemic. 1 We were interested in how confident the people living in Taiwan were in coping with the coronavirus disease 2019 and what factors might relate to the level of confidence during the COVID-19 pandemic.

The online survey study on COVID-19 in Taiwan recruited participants who were ≥20 years old and lived in Taiwan through a Facebook advertisement on April 10 to April 23, 2020. The disclosure of the study was listed in the first page of the online survey, and participants were voluntary to answer the questionnaires if they agreed. We used the following question adapted from the questionnaire on risk perception of a RID outbreak to assess how confident respondents were in coping with COVID-19: "How confident are you that you can cope well with COVID-19?" 2

The question was rated from 1 (not confident at all) to 5 (very confident). Those who scored 1 or 2 were identified to have a low level of confidence in coping with COVID-19, and those with 4 or 5 were identified as high level of confidence. The definition of confidence in our study is comparable to self-efficacy, representing the individuals' beliefs that they have the ability to do specific tasks in the future. 3 We This article is protected by copyright. All rights reserved.

also collected the data of respondents' age, gender, occupational background (healthcare worker or not), self-reported mental and physical health status before the COVID-19 pandemic, 4 risk perception of COVID-19, 5 adequacy of resources and support against COVID-19, and perceived social support (Supplementary Table S1 ).

This study was approved by the Institutional Review Board of Kaohsiung Medical University Hospital and followed the provision of the Declaration of Helsinki.

In total, the data of 1970 respondents were analyzed. Of them, 268 (13.6%) respondents reported a low level of confidence, 751 (38.1%) of them replied neutral, and 951 (48.3%) had high level of confidence in coping with COVID-19. The reliability and validity test for above measurements were estimated, indicating satisfactory as acceptable range (Supplementary Table S1~S3 ). We used the stepwise linear regression to examine the factors related to the level of confidence ( Table 1 ).

The results indicated that multi-dimensional factors were significantly associated with a higher level of confidence in coping with COVID-19, including individual factors Table S4 ).

A relatively low proportion (13.6%) of respondents reported low confidence in coping with COVID-19, which might result from timely border control, application of big data analytics, and experienced teams of officials in Taiwan. Taiwan experienced the severe outbreak of SARS. 5 The experience with SARS made many Taiwanese people vigilant against COVID-19, which has aided in COVID-19 prevention.

Higher social support may decrease the uncertain and fearful feeling in the pandemic and increase confidence in coping with COVID-19. However, the ways people are used to interact with and provide social support to others may be interrupted during the pandemic. Health professionals should develop alternative ways such as telephone visits to provide social support for the public, especially for those who are quarantined. Sufficient protective equipment, information about COVID-19, financial support, and medical resources were significantly associated with higher confidence. Research also found that up-to-date and accurate health information about COVID-19 and sufficient protective equipment were associated with less psychological impact. 6 How to deliver information, protective equipment and resources to all people requires planning ahead of time.

Research reported that current physical symptoms and poor self-rated health status were significantly associated with a greater psychological distress. 7 This study found that better self-rated mental and physical health before COVID-19 outbreak were associated with higher confidence, indicating that good health status may This article is protected by copyright. All rights reserved.

contribute to confronting the unanticipated pandemic with confidence.

Females had lower confidence in coping with COBVID-19 than males and transgenders. A study in Spain also found that females reported more severe distress and loneliness than males during the lock-down period of COVID-19. 8 Older people had poorer clinical features and prognosis than younger ones if being infected. 9,10

Older people may also have more difficulties in obtain the information necessary to coping with the pandemic. These disadvantages may damage older people's morale and confidence. Healthcare workers may have more abundant knowledge about COVID-19 and thus have higher confidence in coping with COVID-19 than nonhealthcare workers.

In conclusion, we found multi-dimensional factors related to the level of confidence in coping with COVID-19. Health professionals should take these factors into consideration when developing strategies for enhancing people's confidence in coping with RID in future.

All authors declare that they have no conflicts of interest. This article is protected by copyright. All rights reserved.

Psychosocial factors influencing the practice of preventive behaviors against the severe acute respiratory syndrome among older Chinese in Hong Kong