{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:35:11Z","timestamp":1775147711230,"version":"3.50.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T00:00:00Z","timestamp":1755043200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2022K2A9A2A06043647"],"award-info":[{"award-number":["2022K2A9A2A06043647"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["7221101017"],"award-info":[{"award-number":["7221101017"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Pandemic fatigue has emerged as a significant public health challenge, particularly in countries that implemented prolonged COVID-19 public health and social measures (PHSM). Understanding the factors contributing to pandemic fatigue and its impact on adherence to health protective behaviors is essential for sustaining public engagement in long-term disease management. This study examines pandemic fatigue in China and South Korea, two countries that maintained prolonged COVID-19 public health and social measures, to identify key predictors and explore its relationship with health protective behaviors. Online surveys were conducted in March 2023 to measure pandemic fatigue levels. To examine the relationships between pandemic fatigue, its predictors (perceived risk, efficacy beliefs, and daily life changes), and health protective behaviors, linear regression and mediation effect analyses were performed. The results indicated that the level of pandemic fatigue was 3.67 in South Korea and 3.47 in China, which was higher than previous research. High efficacy beliefs were associated with lower pandemic fatigue in both countries, while daily life changes had mixed effects. Pandemic fatigue has a significant impact on the adoption of health protective behaviors, with the exception of the practice of resting when unwell. The findings highlight the necessity of reinforcing efficacy beliefs through risk communication for a sustainable pandemic response. Given that risk perception declined over time, traditional fear-based health messages may be less effective in prolonged pandemics. Instead, risk communication strategies that emphasize a sense of control and provide clear, actionable guidance may help sustain public engagement. Furthermore, addressing the daily life changes faced by citizens and creating environments that facilitate the adoption of health-protective behaviors (e.g., access to paid sick leave) are important as long-term pandemic strategies.<\/jats:p>","DOI":"10.1371\/journal.pone.0329262","type":"journal-article","created":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:44:47Z","timestamp":1755107087000},"page":"e0329262","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Korean and Chinese citizens\u2019 pandemic fatigue and related factors amidst the prolonged COVID-19 pandemic: Implications for risk communication"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4099-5351","authenticated-orcid":true,"given":"Yubin","family":"Lee","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenyuan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minjung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Deng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9365","authenticated-orcid":true,"given":"Jue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9869-014X","authenticated-orcid":true,"given":"Myoungsoon","family":"You","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,8,13]]},"reference":[{"key":"pone.0329262.ref001","unstructured":"WHO. Statement on the fifteenth meeting of the IHR (2005) Emergency Committee on the COVID-19 pandemic. 2023. https:\/\/www.who.int\/news\/item\/05-05-2023-statement-on-the-fifteenth-meeting-of-the-ihr-(2005)-emergency-committee-on-the-covid-19-pandemic"},{"key":"pone.0329262.ref002","volume-title":"From emergency response to long-term COVID-19 disease management: sustaining gains made during the COVID-19 pandemic","author":"WHO","year":"2023"},{"key":"pone.0329262.ref003","volume-title":"Considerations for implementing and adjusting public health and social measures in the context of COVID-19","author":"WHO","year":"2023"},{"key":"pone.0329262.ref004","volume-title":"Pandemic fatigue: reinvigorating the public to prevent COVID-19 - policy framework for supporting pandemic prevention and management","author":"WHO","year":"2020"},{"issue":"1","key":"pone.0329262.ref005","doi-asserted-by":"crossref","first-page":"6352","DOI":"10.1038\/s41467-023-42063-2","article-title":"Development and validation of the pandemic fatigue scale","volume":"14","author":"L Lilleholt","year":"2023","journal-title":"Nat Commun"},{"issue":"48","key":"pone.0329262.ref006","doi-asserted-by":"crossref","DOI":"10.1073\/pnas.2201266119","article-title":"Pandemic fatigue fueled political discontent during the COVID-19 pandemic","volume":"119","author":"F J\u00f8rgensen","year":"2022","journal-title":"Proc Nat Acad Sci"},{"key":"pone.0329262.ref007","first-page":"208","volume-title":"COVID-19 prevalence and well-being: lessons from East Asia","author":"M Ma","year":"2021"},{"issue":"10","key":"pone.0329262.ref008","first-page":"2121","article-title":"Estimate of COVID-19 deaths, China, December 2022\u2013February 2023","volume":"29","author":"Z Du","year":"2023","journal-title":"Emerg Inf Dis"},{"key":"pone.0329262.ref009","doi-asserted-by":"crossref","DOI":"10.1596\/38372","volume-title":"Country case study: the republic of Korea","author":"T Lee","year":"2022"},{"key":"pone.0329262.ref010","volume-title":"KDCA lowers COVID-19 alert level","year":"2023"},{"issue":"1","key":"pone.0329262.ref011","doi-asserted-by":"crossref","first-page":"29","DOI":"10.29152\/KOIKS.2023.54.1.29","article-title":"A Comparative analysis of government responses to COVID-19 in the United States, China, and South Korea: lessons from the early stage of the pandemic","volume":"54","author":"H Jung","year":"2023","journal-title":"Korea Observer"},{"key":"pone.0329262.ref012","unstructured":"WHO. 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COVID-19: How to include marginalized and vulnerable people in risk communication and community engagement. 2020."},{"key":"pone.0329262.ref027","doi-asserted-by":"crossref","first-page":"104314","DOI":"10.1016\/j.euroecorev.2022.104314","article-title":"The value of sick pay","volume":"151","author":"A Adams-Prassl","year":"2023","journal-title":"European Eco Rev"},{"key":"pone.0329262.ref028","volume-title":"Paid sick leave to protect income, health and jobs through the COVID-19 crisis","author":"OECD","year":"2020"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329262","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T17:44:52Z","timestamp":1755107092000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0329262"}},"subtitle":[],"editor":[{"given":"Mohd Ismail","family":"Ibrahim","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,8,13]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0329262","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,13]]}}}