Psychological Wellbeing and Psychological Distress in the Elderly during the COVID-19 Pandemic

Abstract

BACKGROUND: The elderly population is deemed to be the most vulnerable to the effects of the COVID-19 pandemic. From March 2020 to April 2022, the implementation of psychological distancing is still being applied in Indonesia. In the light of the pandemic, mental health problems among the elderly require further exploration. This study examines the mental health status of the elderly during the COVID-19 pandemic in Indonesia and the factors that affect their mental health, such as loneliness and attachment to God.

METHODS: A sequential explanatory type of the mixed-method approach was adopted for the purposes of this study. In particular, the researchers first conducted a quantitative survey, analyzed its results, and then explained them in more detail using qualitative research.

RESULTS: The results show that loneliness is a predictor of mental health in the elderly, while attachment to God does not correlate with mental health. More specifically, we described that minimal activity, inability to meet children and grandchildren, and inability to recite the Qur’an were the main factors triggering sadness among the elderly during the COVID-19 pandemic. Furthermore, we defined that elderly people use productive and religious activities, and communication as main coping strategies.

CONCLUSION: Loneliness has been a serious problem for the elderly during the COVID-19 pandemic, impacting their mental health. The findings of this research can be used as a basis or reference for maintaining the mental health of the elderly during the pandemic.

Keywords

mental health / loneliness / attachment to God / COVID-19 pandemic / elderly

References

[1] Hiscott J, Alexandridi M, Muscolini M, Tassone E, Palermo E, Soultsioti M, Zevini A. The global impact of the coronavirus pandemic. Cytokine Growth Factor Rev. 2020 Jun;53:1–9. doi: 10.1016/j.cytogfr.2020.05.010.

[2] Loh HC, Looi I, Ch’ng ASH, Goh KW, Ming LC, Ang KH. Positive global environmental impacts of the COVID-19 pandemic lockdown: a review. GeoJournal. 2021 Jul 23:1–13. doi: 10.1007/s10708-021-10475-6.

[3] Yarrington JS, Lasser J, Garcia D, Vargas JH, Couto DD, Marafon T, Craske MG, Niles AN. Impact of the COVID-19 Pandemic on Mental Health among 157,213 Americans. J Affect Disord. 2021 May 1;286:64–70. doi: 10.1016/j.jad.2021.02.056.

[4] Pan K-Y, Kok AAL, Eikelenboom M, Horsfall M, Jörg F, Luteijn RA, Rhebergen D, Oppen Pv, Giltay EJ, Penninx BWJH. The mental health impact of the COVID-19 pandemic on people with and without depressive, anxiety, or obsessive-compulsive disorders: a longitudinal study of three Dutch case-control cohorts. The Lancet Psychiatry. 2021;8(2):121–129. doi: 10.1016/s2215-0366(20)30491-0.

[5] Johnson S, Dalton-Locke C, Vera San Juan N, Foye U, Oram S, Papamichail A, Landau S, Rowan Olive R, Jeynes T, Shah P, et al. Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff. Soc Psychiatry Psychiatr Epidemiol. 2021 Jan;56(1):25–37. doi: 10.1007/s00127-020-01927-4.

[6] Boden M, Zimmerman L, Azevedo KJ, Ruzek JI, Gala S, Abdel Magid HS, Cohen N, Walser R, Mahtani ND, Hoggatt KJ, et al. Addressing the mental health impact of COVID-19 through population health. Clin Psychol Rev. 2021 Apr;85:102006. doi: 10.1016/j.cpr.2021.102006.

[7] Thome J, Deloyer J, Coogan AN, Bailey-Rodriguez D, da Cruz ESOAB, Faltraco F, Grima C, Gudjonsson SO, Hanon C, Holly M, et al. The impact of the early phase of the COVID-19 pandemic on mental-health services in Europe. World J Biol Psychiatry. 2021 Sep;22(7):516–525. doi: 10.1080/15622975.2020.1844290.

[8] Wang Y, Shi L, Que J, Lu Q, Liu L, Lu Z, Xu Y, Liu J, Sun Y, Meng S, et al. The impact of quarantine on mental health status among general population in China during the COVID-19 pandemic. Mol Psychiatry. 2021 Sep;26(9):4813–4822. doi: 10.1038/s41380-021-01019-y.

[9] Kola L, Kohrt BA, Hanlon C, Naslund JA, Sikander S, Balaji M, Benjet C, Cheung EYL, Eaton J, Gonsalves P, et al. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry. 2021 Jun;8(6):535–550. doi: 10.1016/S2215-0366(21)00025-0.

[10] Ravens-Sieberer U, Kaman A, Erhart M, Devine J, Schlack R, Otto C. Impact of the COVID-19 pandemic on quality of life and mental health in children and adolescents in Germany. Eur Child Adolesc Psychiatry. 2021 Jan 25. doi: 10.1007/s00787-021-01726-5.

[11] Herdian H, Qingrong C. Mental Health in the elderly during the Pandemic in Indonesia. J Clin Dev Psychol. 2021;3(2):1–9.

[12] Dozois DJA. Anxiety and depression in Canada during the COVID-19 pandemic: A national survey. Can Psychol. 2021;62(1):136–142.

[13] Turna J, Zhang J, Lamberti N, Patterson B, Simpson W, Francisco AP, Bergmann CG, Ameringen MV. Anxiety, depression and stress during the COVID-19 pandemic: Results from a cross-sectional survey. J Psychiatr Res. 2021 May;137:96–103. doi: 10.1016/j.jpsychires.2021.02.059.

[14] Varma P, Junge M, Meaklim H, Jackson ML. Younger people are more vulnerable to stress, anxiety and depression during COVID-19 pandemic: A global cross-sectional survey. Prog Neuropsychopharmacol Biol Psychiatry. 2021 Jul 13;109:110236. doi: 10.1016/j.pnpbp.2020.110236.

[15] Ozamiz-Etxebarria N, Idoiaga Mondragon N, Bueno-Notivol J, Pérez-Moreno M, Santabárbara J. Prevalence of Anxiety, Depression, and Stress among Teachers during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis. 2021;11(9):1172.

[16] Hawes MT, Szenczy AK, Klein DN, Hajcak G, Nelson BD. Increases in depression and anxiety symptoms in adolescents and young adults during the COVID-19 pandemic. Psychol Med. 2021 Jan 13:1–9. doi: 10.1017/S0033291720005358.

[17] Faisal RA, Jobe MC, Ahmed O, Sharker T. Mental Health Status, Anxiety, and Depression Levels of Bangladeshi University Students During the COVID-19 Pandemic. Int J Ment Health Addict. 2021 Jan 4:1–16. doi: 10.1007/s11469-020-00458-y.

[18] Bareeqa SB, Ahmed SI, Samar SS, Yasin W, Zehra S, Monese GM, Gouthro RV. Prevalence of depression, anxiety and stress in china during COVID-19 pandemic: A systematic review with meta-analysis. Int J Psychiatry Med. 2021 Jul;56(4):210–227. doi: 10.1177/0091217420978005.

[19] Kibbey MM, Fedorenko EJ, Farris SG. Anxiety, depression, and health anxiety in undergraduate students living in initial US outbreak “hotspot” during COVID-19 pandemic. Cogn Behav Ther. 2021 Sep;50(5):409–421. doi: 10.1080/16506073.2020.1853805.

[20] Heinberg LJ, Steffen K. Social Isolation and Loneliness During the COVID-19 Pandemic: Impact on Weight. Curr Obes Rep. 2021 Sep;10(3):365–370. doi: 10.1007/s13679-021-00447-9.

[21] Varga TV, Bu F, Dissing AS, Elsenburg LK, Bustamante JJH, Matta J, van Zon SKR, Brouwer S, Bultmann U, Fancourt D, et al. Loneliness, worries, anxiety, and precautionary behaviours in response to the COVID-19 pandemic: A longitudinal analysis of 200,000 Western and Northern Europeans. Lancet Reg Health Eur. 2021 Mar;2:100020. doi: 10.1016/j.lanepe.2020.100020.

[22] Hansen T, Nilsen TS, Yu B, Knapstad M, Skogen JC, Vedaa O, Nes RB. Locked and lonely? A longitudinal assessment of loneliness before and during the COVID-19 pandemic in Norway. Scand J Public Health. 2021 Nov;49(7):766–773. doi: 10.1177/1403494821993711.

[23] Wickens CM, McDonald AJ, Elton-Marshall T, Wells S, Nigatu YT, Jankowicz D, Hamilton HA. Loneliness in the COVID-19 pandemic: Associations with age, gender and their interaction. J Psychiatr Res. 2021 Apr;136:103–108. doi: 10.1016/j.jpsychires.2021.01.047.

[24] Pradana AA, Casman C, Nur’aini N. Pengaruh kebijakan social distancing pada wabah COVID-19 terhadap kelompok rentan di Indonesia. J Kebijak Kesehat Indones JKKI. 2020;9(2):61–67.

[25] Team CC-R. Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12-March 16, 2020. MMWR Morb Mortal Wkly Rep. 2020 Mar 27;69(12):343–346. doi: 10.15585/mmwr.mm6912e2.

[26] Tobing C, Wulandari ISM. Tingkat Kecemasan bagi Lansia yang Memiliki Penyakit Penyerta Ditengah Situasi Pandemik Covid-19 di Kecamatan Parongpong, Bandung Barat. Community Publ Nurs. 2021 April;9(2):135–142.

[27] Lumbantoruan M, Sirait A, Aritonang J. Kajian Kecemasan Lansia Di Masa Pandemi Covid 19. Ahmar Metastasis Health Journal. 2021;1(2):43–48. doi: 10.53770/amhj.v1i2.48.

[28] Stolz E, Mayerl H, Freidl W. The impact of COVID-19 restriction measures on loneliness among older adults in Austria. Eur J Public Health. 2021 Feb 1;31(1):44–49. doi: 10.1093/eurpub/ckaa238.

[29] Bonab BG, Namini ASY. The Relationship between Attachment to God and Reliance on God. Procedia — Social and Behavioral Sciences. 2010;5:1098–1104. doi: 10.1016/j.sbspro.2010.07.242.

[30] Homan KJ. A mediation model linking attachment to God, self-compassion, and mental health. Ment Health Relig Cult. 2014;17(10):977–989.

[31] Kent BV, Bradshaw M, Uecker JE. Forgiveness, Attachment to God, and Mental Health Outcomes in Older U.S. Adults: A Longitudinal Study. Res Aging. 2018 Jun;40(5):456–479. doi: 10.1177/0164027517706984.

[32] Creswell JW, Creswell JD. Research Design Qualitative, Quantitative, and Mixed Methods Approaches. USA: SAGE Publications; 2017.

[33] Veit CT, Ware JE, Jr. The structure of psychological distress and well-being in general populations. J Consult Clin Psychol. 1983 Oct;51(5):730–742. doi: 10.1037//0022-006x.51.5.730.

[34] Berwick DM, Murphy JM, Goldman PA, Ware JE, Jr., Barsky AJ, Weinstein MC. Performance of a five-item mental health screening test. Med Care. 1991 Feb;29(2):169–176. doi: 10.1097/00005650-199102000-00008.

[35] Miner MH, Ghobary-Bonab B, Dowson MN. Development of a Measure of Attachment to God for Muslims. Rev Relig Res. 2017;59:183–206.

[36] Hudiyana J, Lincoln TM, Hartanto S, Shadiqi MA, Milla MN, Muluk H, Jaya ES. How Universal Is a Construct of Loneliness? Measurement Invariance of the UCLA Loneliness Scale in Indonesia, Germany, and the United States. Assessment. 2021 Jul 23:10731911211034564. doi: 10.1177/10731911211034564.

[37] Miles MB, Huberman AM. Analisis data kualitatif jakarta: Universitas Indonesia. Jakarta: UI press; 1992.

[38] Miller ED. Loneliness in the Era of COVID-19. Front Psychol. 2020;11:2219. doi: 10.3389/fpsyg.2020.02219.

[39] Dahlberg L. Loneliness during the COVID-19 pandemic. Aging Ment Health. 2021 Jul;25(7):1161–1164. doi: 10.1080/13607863.2021.1875195.

[40] Cohn-Schwartz E, Vitman-Schorr A, Khalaila R. Physical distancing is related to fewer electronic and in-person contacts and to increased loneliness during the COVID-19 pandemic among older Europeans. Qual Life Res. 2022 Apr;31(4):1033–1042. doi: 10.1007/s11136-021-02949-4.

[41] Rumas R, Shamblaw AL, Jagtap S, Best MW. Predictors and consequences of loneliness during the COVID-19 Pandemic. Psychiatry Res. 2021 Jun;300:113934. doi: 10.1016/j.psychres.2021.113934.

Funding

Institution of Research and Community Services project, Universitas Muhammadiyah Purwokerto, Fundamental Research IIПроект Института исследований и общественных услуг, Университет Мухаммадия Пурвокерто, Фундаментальные исследования II(A.11-1/579-5.Pj./LPPM/XII/2021)

RIGHTS & PERMISSIONS

Herdian H., Suwarti S., Estria S.R.