{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T03:51:25Z","timestamp":1747194685065,"version":"3.40.5"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec id=\"S2056472424007695_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>COVID-19 was a collective traumatic event; however, different individuals may have perceived it differently.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007695_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>This study investigated what older people in a collective culture perceived as stressful during COVID-19 and examined how different stressors related to COVID-19 infection and mental health risks.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007695_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>Thirty-six participants from diverse backgrounds engaged in a three-round Delphi study to generate items for a COVID-19-related stress scale for older adults (CSS-OA). Subsequently, 4674 people (aged \u226560 years) participated in a cross-sectional telephone survey; interviewers collected their responses to CSS-OA and information about COVID-19 infection, depressive symptoms, anxiety, loneliness and demographics. Exploratory factor analysis and confirmatory factor analysis were conducted on CSS-OA. A multiple indicator multiple cause (MIMIC) model was used to examine associations between CSS-OA and other measures.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007695_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>The Delphi process generated eight items, all secondary or tertiary stressors related to infection. Exploratory factor analysis revealed a three-factor model, and confirmatory factor analysis confirmed an excellent fit (comparative fit index = 0.99, root mean square error of approximation = 0.06). Pre-existing mental health conditions, having family members\/friends infected with COVID-19, loneliness, anxiety and depressive symptoms were associated with higher stress. Conversely, self-infection with COVID-19, older age, being female and living alone were negatively associated with some domains of CSS-OA (all <jats:italic>P<\/jats:italic> &lt; 0.05).<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472424007695_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>The Delphi process enhanced our understanding of what older people perceived as stressful, much of which resulted from certain healthcare strategies and reflected cultural influences. These and the MIMIC results highlight the need to balance public health policies with respect to infectious diseases and older people's mental health and quality of life.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2024.769","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T09:24:10Z","timestamp":1729848250000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["\u2018I am more stressed if my infection affects others\u2019: development of a COVID-19-related stress scale in older people and examination of its validity and associations with mental health risks"],"prefix":"10.1192","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-5342","authenticated-orcid":false,"given":"Tianyin","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lesley Cai Yin","family":"Sze","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Kwok Lun","family":"Yiu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin Lok Yan","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dara Kiu Yi","family":"Leung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wai-wai","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4160-1713","authenticated-orcid":false,"given":"Jennifer","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaqi","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1331-942X","authenticated-orcid":false,"given":"Gloria","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terry","family":"Lum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"S2056472424007695_ref17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"S2056472424007695_ref29","doi-asserted-by":"publisher","DOI":"10.1177\/096228029900800102"},{"key":"S2056472424007695_ref24","doi-asserted-by":"publisher","DOI":"10.1177\/0164027504268574"},{"key":"S2056472424007695_ref21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.05.007"},{"key":"S2056472424007695_ref16","first-page":"946","article-title":"Who is the most stressed during the COVID-19 pandemic? 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