Adherence and Psychosocial Well-Being During Pandemic-Associated Pre-deployment Quarantine

Abstract

Background: With the purpose of preventing SARS-Cov-2 traveling with the troops, pre-deployment and post-deployment quarantine are mandatory for the German military. This study investigates which factors could be addressed in order to facilitate adherence and mental health during isolation.Method: Six hundred three soldiers completed questionnaires at the beginning and at the end of pre-deployment quarantine: Mini-SCL (BSI), Perceived Social Support (FSozU-K22), Unit Cohesion, Military Quarantine Adherence Questionnaire (MQAQ), and quarantine-associated factors including informedness about Covid-19, perceived individual risk, benefit of quarantine, clarity of quarantine protocol, need of intimacy, social norms, stigma, practicality of the quarantine, financial disadvantages, boredom, and health promoting leadership.Results: Using stepwise regression analyses, up to 57% of the quarantine adherence was explained by social norms, boredom, perceived benefit/effectiveness of the quarantine, clear communication of the quarantine protocol and perceived risk of an infection, with social norms explaining 43%. In respect to mental health (Mini-SCL) at the beginning of quarantine, only 15% is explained by being in a partnership, (un)fulfilled need for bonding/intimacy, perceived unit cohesion, and perceived social support. Up to 20 % of the variance in mental health at the end of quarantine is explained by accumulated days of isolation before pre-deployment quarantine, age, clear communication of the quarantine protocol, perceived social support, fulfilled need for bonding/intimacy and perceived stigma. Mental health and quarantine adherence did correlate significantly, but to a slight extent. No differences between the beginning and the end of pre-deployment quarantine were found for the overall group in respect to mental health, quarantine adherence, perceived social support and perceived unit cohesion, while their trajectories differed for different subgroups including age, gender, rank, and accumulated days of quarantine: With increasing accumulated days of isolation prior to pre-deployment quarantine, mental health declined over the course of quarantine, though to a small degree.Conclusion: Findings suggest that addressing the norms of fellow soldiers and dependents alike could contribute to quarantine adherence in pre-deployment quarantine. Ongoing research should examine long-term effects on mental health, including these of accumulated days of quarantine, also taking into account post-deployment quarantine.

Deployment-related quarantining—a risk or resilience factor for German military service members? A prospective analysis during the third–fifth waves of COVID-19

“…The only two studies, to our knowledge, studying military mental health associated with deployment-related quarantining have not found indications for higher incidence or prevalence rates of mental disorders following quarantining (35,36), although a considerable percentage of sleeping problems was reported (32%) in one study (35,37), which is often a precursor for mental health disorders (38)(39)(40)(41). At the same time, differing trajectories of more vulnerable groups might be masked, when only statistic differences in means are explored (25,26).…”

“…Seven factors yielded satisfactory to good reliability (consistency; 0.73 ≤ α ≤ 0.83), while the two most heterogeneous scales, namely, "fulfilled need for intimacy/bonding" and "clear communication of the quarantine protocol" (α ≤ 0.58), had to be z-standardized to reach satisfactory consistency (α > 0.7): For consistency reasons, all items were z-standardized before calculating scale means. More details on the scales and their validation have been reported previously (36,59).…”

“…(p < 0.001)] but no difference across pre-deployment quarantine (p = 1; see Figure 2). Following up on the interaction effect for accumulated previous quarantining experience (36), no interaction effect was found for the accumulated experience of quarantining before pre-deployment quarantine [V = 0.018, F( 2 Mental health trajectories were identified in a two-step exploratory analysis: In the first step, three trajectories were identified: A stable trajectory was defined as one that does not change more than one SD over time, an improvement in mental health was defined as a decrease in mental health symptomatology by more than one SD over time, a deterioritaion in mental health was defined in mental health symptomatology (GSI) was defined as a change of more than one SD over time. These resulted in the following trajectories (see Figure 4; Table 3): 79.2% were identified as stable, for 12.6% the GSI decreased post-deployment (adaptation), and for 4.6% the GSI increased.…”

The impact of the pandemic on the perception of stress and danger, and the adjustment of psychiatric and general medical staff of German military hospitals

“…The manageability of the pandemic situation in many hospitals in Germany, but especially in the Bundeswehr hospitals, may have contributed to these results. Hierarchical structures in the military and a military-specific unit cohesion also might have positive effects on coping strategies and resilience ( 28 ).…”

US soldiers and the role of leadership: COVID-19, mental health, and adherence to public health guidelines

“…In developing their health communication strategy, organizations like the military should consider the role of leaders, unit climate and individual differences in beliefs about health [ 34 ]. Recent studies have found that individual differences, such as trait reactance, perceived injunctive norms, and COVID-19 conspiracy beliefs, are associated with lower likelihood of engaging in preventive health behaviors [ 34 – 37 ]. While providing individuals with clear rules and accurate information is valuable, public-health messaging driven by data alone risks neglecting how health beliefs factor into health behaviors.…”