Health-related factors of psychological distress during the COVID-19 pandemic among non-health workers in Spain

May combine two claims.

The preventive measures with the lowest assessment values were wearing a mask with or without symptoms (M = 2.62, SD = 1.55), washing hands with hydroalcoholic solution (M = 3.08, SD = 1.24), and washing hands after coughing, touching the nose, or sneezing (M = 3.38, SD = 1.14).

“Conversely, the measurements with the lowest values were: wearing a mask with or without symptoms, M = 2.62 (SD = 1.55); washing hands with hydroalcoholic solution, M = 3.08 (SD = 1.24); and washing hands after coughing, touching the nose, or sneezing, M = 3.38 (SD = 1.14).”

May combine two claims.

The percentage of non-health workers with psychological distress was 70.7% for those without outside spaces at home, compared with 63.2% for those with access to the outdoors.

“The percentage of non-health workers with distress is 70.7% for those without outside spaces at home, as compared to 63.2% for those with access to the outdoors.”

May combine two claims.

Among all non-health workers, people with distress reported all asked symptoms in greater proportion than those without distress: fever, dizziness, breathing difficulties, headache, muscle pain, sore throat, rhinitis, and chills, with over 70% stating all symptoms and over 80% stating the first three.

“Among all non-health workers, people with distress state all the symptoms about which they have been asked in a greater proportion than those who do not suffer psychological distress: fever, dizziness, breathing difficulties, headache, muscle pain, sore throat, rhinitis, and chill, exceeding 70% those stating all the symptoms and 80% those declaring the first three symptoms (Table 3 ).”

May combine two claims.

Among non-health workers in Spain during the COVID-19 pandemic, 71.6% of women had psychological distress compared with 52.4% of men, a statistically significant difference in both those working away from home and those working from home.

“Table 2 shows how 71.6% of women have distress, while this percentage drops to 52.4% in men, a difference that is also statistically significant in both workers working away from home and those doing so from home.”

• Also stated in: § Discussion · plain

  “A higher level of psychological distress has been observed among women, as in most previous studies (Rodriguez-Rey et al., 2020, Wang et al., 2020), being so among health workers (Lopez-Atanes et al., 2020), patients, their families, and general society (Leung et al., 2020).”

May combine two claims.

The highest GHQ-12 item scores were for being unable to enjoy normal activities (mean 2.74, SD 0.90) and for feeling constantly overwhelmed and stressed (mean 2.67, SD 0.90).

“The highest values were related to the item “Have you been able to enjoy your normal activities every day?” M = 2.74 (SD = 0.90), and the item “Have you felt constantly overwhelmed and stressed?” M = 2.67 (SD = 0.90).”

May combine two claims.

Other risk factors for psychological distress were having a house without outdoor space (OR = 1.367, 95% CI = 1.001-1.867), the number of symptoms (OR = 1.195, 95% CI = 1.089-1.738), and having been in contact with contaminated people or material (OR = 1.332, 95% CI = 1.021-1.738).

“Other risk factors were to have a house without outdoor space OR = 1.367 (95% CI = 1.001–1.867), the number of symptoms OR = 1.195 (95% CI = 1.089–1.738), and having been in contact with contaminated people or material OR = 1.332 (95% CI = 1.021–1.738).”

May combine two claims.

In the proposed model for the level of psychological distress among non-health workers, the predictive capacity was 11.3%, correctly classifying 66.5% of non-health workers, with sensitivity 25.5% and specificity 88.4%.

“In the proposed model for the level of psychological distress experienced among non-health workers, the predictive capacity was 11.3%, correctly classifying 66.5% of non-health workers. Sensitivity (proportion of properly classified professionals without distress) of 25.5% and specificity (proportion of properly classified professionals without distress) of 88.4%.”

May combine two claims.

6.9% of non-health workers had required care in a health centre, hospital, or clinic during the last 14 days, with 5 cases (0.5%) hospitalised and 2.6% quarantined during that period.

“6.9% of non-health workers had required care in a health centre, hospital, or clinic during the last 14 days, with 5 cases (0.5%) hospitalised and 2.6% quarantined during that period.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The lowest GHQ-12 item score was for seeing oneself as a worthless person (mean 1.36, SD 0.72).

“The lowest value was obtained in the item “Have you seen yourself as a worthless person?” M = 1.36 (SD = 0.72).”

May combine two claims.

The percentage of those who claimed to have had an infected family member, or did not know it, was 16.9%, with no statistically significant differences between having or not psychological distress or working away from home or doing so from home.

“The percentage of those who claimed to have had an infected family member, or not knowing it, was 16.9%, with no statistically significant differences between having or not psychological distress or working away from home or doing so from home.”

May combine two claims. The quote only partly states this claim.

Among non-health workers who work away from home, the level of psychological distress was predicted by being a woman (OR = 1.787, 95% CI = 1.187-2.690), the number of symptoms (OR = 1.241, 95% CI = 1.085-1.421), and being a self-employed worker; working in a private company (OR = 0.487, 95% CI 0.256-0.928) and working in a public company (OR = 0.395, 95% CI 0.199-0.785) acted as protective factors

“The level of psychological distress among non-health workers who work away from home is predicted by the following variables: being a woman OR = 1.787 (95% CI = 1.187–2.690); the number of symptoms OR = 1.241 (95% CI = 1.085–1.421); and being a self-employed worker. Working in a private company acts as a protective factor, as compared to being a self-employed worker, OR = 0.487 (0.256–0.928); and”

• Also stated in: § Conclusions · plain

  “The level of psychological distress among non-health workers who work away from home is predicted at 67.5% by the variables: being female, being self-employed as compared to private or public company workers, and the number of symptoms. These results are obtained with a sensitivity of 21.2% and a specificity of 90.0%.”

May combine two claims.

Preventive measures with higher assessment values among non-health workers were washing hands with soap and water (M = 4.67, range 1-5, SD = 0.56), washing hands after touching potentially contaminated objects (M = 4.51, SD = 0.75), and leaving at least one and a half metres of distance (SD = 0.77).

“Preventive measures with higher assessment values among non-health workers were: washing hands with soap and water, M = 4.67 (range: 1–5; SD = 0.56); washing hands after touching potentially contaminated objects, M = 4.51 (SD = 0.75); and leaving at least one and a half metres of distance (SD = 0.77).”

• Also stated in: § Conclusions · plain

  “In addition, the most valued measures by all non-health workers were hand washing with soap and water, hand washing after contact with potentially contaminated objects, and social distancing measures.”

May combine two claims.

28.0% of those working away from home had 3 or more symptoms, rising to 30.8% in those working from home.

“28.0% of those working away from home have 3 or more symptoms, rising up to 30.8% in those who work from home.”

May combine two claims.

A statistically significant difference was found among those with or without psychological distress in washing hands with hydroalcoholic solution (p = .009) and wearing a mask with or without symptoms (p = .009); this difference was also seen in workers who work away from home, but not in those who work from home.

“A statistically significant difference is found among those with or without psychological distress in the following measures: washing hands with hydroalcoholic solution (p = .009) and wearing a mask with or without symptoms (p = .009). This difference is also seen in workers who work away from home, but not in those who work from home (Table 5 ).”

May combine two claims.

The mean psychological distress score was slightly higher for non-health workers working away from home (4.61, SD 3.39) than for those working from home (4.44, SD 3.45), and this difference was not statistically significant.

“being slightly higher the percentage among those who worked away from home (67.3%), with M = 4.61 (SD = 3.39) than those who worked from home M = 4.44 (SD = 3.45), while not being this a statistically significant difference.”

May combine two claims.

In the sample of non-health workers, 65.1% had psychological distress according to a GHQ-12 score of 3 or more, with a mean score of 4.51 and standard deviation of 3.42.

“Table 1 shows how 65.1% of all non-health workers had psychological distress (GHQ-12 cut point ≥ 3), with M = 4.51 (SD = 3.42)”

Probably not a substantial claim: may not pass S3 (load-bearing).

About 25% of non-health workers had a chronic disease.

“About 25% had a chronic disease.”

May combine two claims.

Among non-health workers, the mean number of common physical symptoms associated with COVID-19 was 2.11 (SD = 1.83) for those with psychological distress and 1.35 (SD = 1.46) for those without, with p < 0.001 in all cases.

“within a range of 0–10, M = 2.11 (SD = 1.83) for workers showing psychological distress versus M = 1.35 (SD = 1.46) for those who do not suffer it, this is for all non-health workers including those who work away from home and those working from home, with p < 0.001 in all cases.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

2.2% of those working away from home and 2.8% of those working from home were quarantined when they completed the questionnaire.

“2.2% of those working away from home and 2.8% of those working from home were quarantined when they completed the questionnaire.”

May combine two claims.

Among workers who perform their activity away from home, the only health-status variable showing a statistically significant difference with presence of psychological distress was taking medications (p = .039); this was not the case among workers who work from home.

“When analysing the variables related to the health status and the presence of psychological distress, the only one that shows a statistically significant difference among workers who perform their activity away from home is that of taking medications (p = .039). This is not the case among workers who work from home.”

May combine two claims. The quote only partly states this claim.

Among non-health workers who work from home, the level of psychological distress was predicted by being a woman (OR = 2.340, 95% CI = 1.606-3.408), living in a house without outdoor space (OR = 1.569, 95% CI = 1.034-2.381), having a poor perception of health during the last 14 days (OR = 3.132, 95% CI = 1.523-6.441), the number of symptoms (OR = 1.179, 95% CI = 1.038-1.338), and having had contact

“The level of psychological distress among non-health workers who work from home is predicted by the following variables: being a woman OR = 2.340 (95% CI = 1.606–3.408); living in a house without outdoor space OR = 1.569 (95% CI = 1.034–2.381); having a poor perception of health during the last 14 days OR = 3.132 (95% CI = 1.523–6.441); the number of symptoms OR = 1.179 (95% CI = 1.038–1.338); and”

• Also stated in: § Conclusions · plain

  “The level of psychological distress among non-health workers who work from home is predicted at 69.2% by the variables: being a woman, living in a house without outdoor space, having a poor perception of health during the last 14 days, the number of symptoms, and having had contact with contaminated people or material. These results are obtained with a sensitivity of 37.9% and a specificity of 87.”

May combine two claims.

Among non-health workers, 71.6% of women and 52.4% of men had psychological distress.

“71.6% of non-health female workers and 52.4% of non-health male workers had psychological distress”

May combine two claims.

No symptoms were presented in 28.3% of those who work away from home and in 26.8% of those who work from home.

“No symptoms are presented in 28.3% of those who work away, and in 26.8% of those who work from home.”

May combine two claims.

Among men, psychological distress was 58.4% in those working away from home and 46.9% in those working from home.

“having found in the latter differences between those working away from home (58.4%) and those working from home (46.9%).”

• Also stated in: § Discussion · plain

  “The number of workers with distress among men who were working away from home (58.4%) is higher than the number of those who worked from home (46.9%), this difference is not appreciated in women.”

May combine two claims.

The percentage of those who said they had any contact with a person or material suspected of being infected was 45.7%, with statistically significant differences between those with and without psychological distress for both all non-health workers (p = .001) and the subgroup working from home (p = .002).

“The percentage of those who said to have had any contact with “a person or material suspected of being infected” rose to 45.7%, with statistically significant differences between those who had psychological distress and those who did not have it, for both the group of non-health of workers (p = .001) and the sub-group of those working from home (p = .002).”

May combine two claims.

26.5% of non-health workers claimed to have had contact with infected people for more than 15 min or at <2 m away, or did not know if this had occurred; there was a statistically significant difference between those with and without psychological distress (p = .046).

“Table 4 shows how 26.5% of non-health workers claimed to have had “contact with infected people for more than 15 min or at <2 m away“, or “not knowing if this had occurred”. There is a statistically significant difference between those who had psychological distress and those who did not (p = .046).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Only 4 people working away from home (0.8%) and 8 of those working from home (1.3%) had had a COVID-19 diagnostic test performed.

“It should be noted that only 4 people working away from home (0.8%) and 8 of those who work from home (1.3%) have had a COVID-19 diagnostic test performed.”

May combine two claims.

In the present study, only 1.1% (12 cases) responded to have had a diagnostic test performed, with this number lower among workers who worked away from home (0.8%, 4 cases).

“In the present study, only 1.1% (12 cases) responded to have been performed a diagnostic test, being this number lower among workers who worked away from home 0.8% (4 cases).”

• Also stated in: § Conclusions · plain

  “Only specific diagnostic tests were performed for SARS-Cov-2 virus infection to 1.1% of active subjects, with the three most common symptoms being fever, dizziness, and breathing difficulties.”

May combine two claims.

In the present study, self-perceived health proved to be a predictive variable for psychological distress among non-health workers globally, as well as for the sub-group working from home, but there was no statistically significant difference in workers who are active away from home.

“In the present study, this has proven to be a predictive variable for psychological distress among non-health workers globally, as well as for the sub-group working from home. On the contrary, there has been no statistically significant difference in workers who are active away from home, which can be explained by the heterogeneity of this group of workers.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Previous epidemics can help understand phenomena that may occur in the current pandemic.

“While it is true that the world is facing a new type of virus, of unknown and unpredictable behaviour, previous epidemics can be used to understand the phenomena that may occur in the current situation (Edelman et al., 2020, Lee et al., 2007).”

• cites Edelman et al., 2020 sourceNot checked yet

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• cites Lee et al., 2007 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Self-perceived health is a strong predictor of morbidity and is used in most health surveys, COVID-19 studies, and previous pandemic studies.

“Self-perceived health was collected through an item of 5 possible responses ranging from very bad to very good, which is known to be a great predictor of morbidity (Eriksson et al., 2001) and is included in most health surveys, in studies on COVID-19 (Wang et al., 2020), and on previous pandemics (Main et al., 2011)”

• cites Eriksson et al., 2001 sourceNot checked yet

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• cites Wang et al., 2020 sourceNot checked yet

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• cites Main et al., 2011 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Perceived adequate protection is linked to common mental health disorders, post-traumatic stress disorder, worse global health, and emotional problems.

“It has also been observed that the perception of proper protection is associated with common mental health disorders, post-traumatic stress disorder, poorer global health, and emotional problems (Simms et al., 2020, Videgaard, 2020).”

• cites Simms et al., 2020 sourceNot checked yet

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• cites Videgaard, 2020Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The questionnaire was reviewed by 10 health professionals and piloted with 57 people, and no comprehension problems were found.

“Through a literature review on publications of previous epidemics, a first draft questionnaire was prepared to be studied by a group of 10 health professionals consisting of three psychologists, four nurses, and three doctors.”

• Also stated in: § Procedure · plain

  “Once the possible modifications were made, 57 people were chosen by sampling convenience for a piloting, of which 50.9% were men, 56.1% were married, with an average age of 42.10 years (SD = 11.09), and 57.9% of them had postgraduate studies. No doubts or comprehension issues arose about the questionnaire questions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Telework has known positive and negative health effects from past epidemics.

“As in past epidemics, its negative and positive health effects are known (Aguilera et al., 2016, Messenger et al., 2017, Kim et al., 2015).”

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May combine two claims.

The Goldberg GHQ-12 was used to assess psychological distress, and its internal consistency in this study was Cronbach's alpha 0.869.

“To assess the level of psychological distress, and according to the degree of mental health and psychological adjustment, the Goldberg GHQ-12 General Health Questionnaire was used, a self-administered scale of 12 items which allows screening of non-psychotic psychiatric disorders (Goldberg et al., 1997).”

• Also stated in: § Instruments · plain

  “Values equal to or greater than 3 were considered to evidence the presence of psychological adjustment, obtaining an internal consistency index (Cronbach's Alpha of 0.869).”

• cites Goldberg et al., 1997 sourceNot checked yet

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Probably not a substantial claim: may not pass S4 (based).

Knowledge about hygiene, virus transmission, protective measures, and social distancing are modifiable factors that can help workers maintain a positive attitude.

“There are modifiable factors which provide necessary elements to support a positive attitude of the workers, such as: knowledge of hygiene, transmission of the virus, protective measures, and social distancing measures.”

Probably not a substantial claim: may not pass S3 (load-bearing).

During previous epidemics such as SARS-CoV, MERS-CoV, and Ebola, mental health and stress effects were substantial among health workers.

“As has been proven in previous epidemics such as SARS-CoV, in 2002, MERS-CoV, in 2012, or Ebola, between 2014 and 2016, the effects on mental health and stress have been important among this group (Schwartz et al., 2020, Wu et al., 2009)”

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May combine two claims.

The high percentage of psychological distress found in the study can be explained by the time of the pandemic when data were collected, as the field study was carried out at the beginning of the pandemic when deaths and contagion curve was rising.

“The high percentage of psychological distress shown by the results of this study can be explained by the time of the pandemic in which data were collected. Thus, the field study was carried out at the beginning of the pandemic, and at a time when the deaths and contagion curve was rising.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The study received favorable ethical approval from the Research Ethics Committee of Huelva and complied with the Helsinki Declaration.

“The study has the mandatory favourable report by the Research Ethics Committee of Huelva, under the Regional Ministry of Health of Andalusia (PI 036/20), which has verified that it complies with all the principles of ethics set out in the Helsinki Declaration.”

May combine two claims.

In all three models, the Wald test assessed the individual statistical significance of each predictive variable, and the Hosmer-Lemeshow test indicated a good fit of the model, showing no statistical significance, with p-values of 0.928, 0.656, and 0.153.

“In all three models, the Wald test assessed the individual statistical significance of each of the predictive variables, and the Hosmer-Lemeshow test indicated a good fit of the model, showing no statistical significance, with p-values of 0.928, 0.656, and 0.153 respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Health workers face a higher risk of contracting COVID-19.

“Health workers are at increased risk of developing the disease (Wu and McGoogan, 2020) and spreading it (Chang et al., 2020, Instituto de Salud Carlos III, 2020) because of the proximity during treatment of infected people.”

• cites Wu and McGoogan, 2020 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Work stress may impair health workers' immune systems and, with close contact with infected people, may increase their viral exposure.

“In this line, it is thought that work stress can weaken their immune system and, along with close contact with the infected, can lead to exposure to a higher viral load (Rose, 2020).”

• cites Rose, 2020 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Health workers face a higher risk of spreading COVID-19.

“Health workers are at increased risk of developing the disease (Wu and McGoogan, 2020) and spreading it (Chang et al., 2020, Instituto de Salud Carlos III, 2020) because of the proximity during treatment of infected people.”

• cites Chang et al., 2020 sourceNot checked yet

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• cites Instituto de Salud Carlos III, 2020Not checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

Health authorities' communication about risks, treatments, vaccination, and preventive measures may produce anxiety that affects pandemic control.

“In a pandemic situation, the way health authorities communicate to the population the available information on risks, treatments, vaccination opportunities, or the need for preventive measures may lead to levels of anxiety that determine success or failure to control the current pandemic (Asmundson and Taylor, 2020, Chen et al., 2020).”

• cites Asmundson and Taylor, 2020 sourceNot checked yet

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• cites Chen et al., 2020 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

In early Chinese studies, remaining active during lockdown was associated with better health and well-being than not being infected or ceasing work.

“In the first studies developed in China, the effects of confinement (Brooks et al., 2020) were analysed and people who had remained active during this period showed better health and well-being outcomes, as compared to those who had not become infected or stopped working during confinement (Zhang et al., 2020).”

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Participants signed informed consent, and their data were collected anonymously and treated confidentially.

“All data were collected anonymously and treated confidentially. Participants signed an informed consent, stating they were aware of the objectives of the study and agreed to participate in the study voluntarily.”

May combine two claims.

The alterations of loss of sleep, unhappiness, and depression among workers away from home can be justified by their perception of increased risk of contagion to themselves or their families, which may exceed the level of psychological distress caused by permanent confinement of those who work from home.

“Such alterations can be justified by their perception of increased risk of contagion to themselves or their families, and which may exceed the level of psychological distress caused by the permanent confinement of those who work from home (Brooks et al., 2020).”

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Probably not a substantial claim: may not pass S3 (load-bearing).

According to official data, one in four of the infected was a healthcare professional.

“according to official data, one in four of the infected was a healthcare professional (Instituto Carlos III, 2020).”

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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

One consequence of the COVID-19 pandemic is the rapid exponential increase in telework, facilitated by new information technologies and with well-known associated negative effects on health.

“One of the consequences of the COVID-19 pandemic is the rapid exponential increase in telework, facilitated by new information technologies and with well-known associated negative effects on health (Aguilera et al., 2016, Messenger et al., 2017).”

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Probably not a substantial claim: may not pass S3 (load-bearing).

Among professional workers, the availability of protective measures has been a matter of concern associated with fear of self-contagion and that of their families.

“Among professional workers, the availability of protective measures has been a matter of concern associated with the fear of self-contagion and that of their families (Simms et al., 2020).”

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Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

Lower social recognition of non-health essential workers could have conditioned their level of psychological distress, since they were also in close contact with infected people or those suspected of being infected.

“This lower social recognition could have conditioned their level of psychological distress, since they were also in close contact with infected people or suspicious of being infected.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Telework also has positive economic, social, and environmental effects, as well as advantages for the entrepreneur and for the worker.

“However, telework also has positive economic, social, and environmental effects, as well as advantages for the entrepreneur and for the worker (Kim et al., 2015)”

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May combine two claims.

Living in a house with exterior views has been identified as a protective factor for all non-health workers and for those who work from home.

“Living in a house with exterior views has been identified as a protective factor for all non-health workers and for those who work from home.”

May combine two claims.

The economic crisis associated with COVID-19 or insecurity for fear of loss of work also affected the increase of psychological distress of the working population, and this is proven in the results of this study.

“Also, another variable to include is the effect of the economic crisis associated with COVID-19 or insecurity for fear of loss of work, which also affected the increase of the psychological distress of the working population and is proven in the results of this study, as well as its effects on mental health (Karanikolos et al., 2016, Torá et al., 2015).”

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• cites Torá et al., 2015 sourceNot checked yet

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Probably not a substantial claim: may not pass S3 (load-bearing).

The perception of health, evaluated with a question with five answer options, is a good predictor of morbidity.

“It is known that the perception of health, evaluated in the study with a question with five answer options, is a good predictor of morbidity (Eriksson et al., 2001).”

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