Psychological Distress and Protective Behaviors During the COVID-19 Pandemic Among Different Populations: Hong Kong General Population, Taiwan Healthcare Workers, and Taiwan Outpatients

Gary Ka-Ki Chung; Carol Strong; Yat-Hang Chan; Roger Yat-Nork Chung; Jung-Sheng Chen; Yi-Hsuan Lin; Ru-Yi Huang; Chung-Ying Lin; Nai-Ying Ko

doi:10.3389/fmed.2022.800962

Psychological Distress and Protective Behaviors During the COVID-19 Pandemic Among Different Populations: Hong Kong General Population, Taiwan Healthcare Workers, and Taiwan Outpatients

Front Med (Lausanne). 2022 Feb 15:9:800962. doi: 10.3389/fmed.2022.800962. eCollection 2022.

Authors

Gary Ka-Ki Chung¹, Carol Strong², Yat-Hang Chan¹, Roger Yat-Nork Chung^{1

3}, Jung-Sheng Chen⁴, Yi-Hsuan Lin⁵, Ru-Yi Huang^{6

7}, Chung-Ying Lin^{2

8

9

10}, Nai-Ying Ko⁵

Affiliations

¹ CUHK Institute of Health Equity, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
² Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
³ The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
⁴ Department of Medical Research, E-Da Hospital, Kaohsiung, Taiwan.
⁵ Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁶ Department of Family and Community Medicine, E-Da Hospital, Kaohsiung, Taiwan.
⁷ School of Medicine for International Students, College of Medicine, I-Shou University, Kaohsiung, Taiwan.
⁸ Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁹ Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
¹⁰ Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Purpose: The novel coronavirus disease 2019 (COVID-19) caused psychological distress and changed human living styles. However, rare studies have examined the psychological distress and protective behaviors across different populations. Therefore, the present study aimed to assess psychological distress, protective behaviors, and potential predictors of psychological distress and protective behaviors across the Hong Kong general population, Taiwan healthcare workers, and Taiwan outpatients.

Methods: A cross-sectional design was used to recruit participants from Hong Kong and Taiwan. Telephone interviews were carried out for Hong Kong participants (n = 1,067; 30.2% male participants); online surveys were used for Taiwan healthcare workers (n = 500; 8.0% male participants) and Taiwan outpatients (n = 192; 32.8% male participants). All the participants completed questions on psychological distress and protective behaviors. Multiple linear regressions and multivariable logistic regressions were employed to explore the potential predictors of psychological distress and protective behaviors, respectively.

Results: Hong Kong participants had significantly lower levels of psychological distress than Taiwan participants [mean (SD) = 0.16 (0.39) vs. 0.47 (0.59) in healthcare workers and 0.46 (0.65) in outpatients; p < 0.001]. Hong Kong participants (51.7%) and Taiwan outpatients had more people showing fear of COVID-19 (52.0%) than Taiwan healthcare providers (40.8%; p < 0.001). Moreover, Hong Kong participants engaged the most in protective behaviors, followed by Taiwan healthcare providers and Taiwan outpatients (p < 0.001). Moreover, being a female, fear of COVID-19 and worry about personal savings were associated with protective behaviors in general.

Conclusions: Despite the greater COVID-19 severity and fear of COVID-19 in Hong Kong, the general population in Hong Kong experienced less psychosocial distress with higher compliance to protective behaviors than the other groups in Taiwan.

Keywords: Asia; COVID-19; infection; protective behavior; psychological distress.