Resilience of people with chronic medical conditions during the COVID-19 pandemic: a 1-year longitudinal prospective survey

Abstract

Backgrounds Individuals with chronic medical conditions are considered highly exposed to COVID-19 pandemic stress, but emerging evidence is demonstrating that resilience is common even among them. We aimed at identifying sustained resilient outcomes and their predictors in chronically ill people during the first year of the pandemic. Methods This international 4-wave 1-year longitudinal online survey included items on socio-demographic characteristics, economic and living situation, lifestyle and habits, pandemic-related issues, and history of mental disorders. Adherence to and approval of imposed restrictions, trust in governments and in scientific community during the pandemic were also investigated. The following tools were administered: the Patient Health Questionnaire, the Generalized Anxiety Disorder scale, the PTSD Checklist DSM-5, the Oslo Social Support Scale, the Padua Inventory, and the Portrait Values Questionnaire. Results One thousand fifty-two individuals reporting a chronic condition out of 8011 total participants from 13 countries were included in the study, and 965 had data available for the final model. The estimated probability of being “sustained-resilient” was 34%. Older male individuals, participants employed before and during the pandemic or with perceived social support were more likely to belong to the sustained-resilience group. Loneliness, a previous mental disorder, high hedonism, fear of COVID-19 contamination, concern for the health of loved ones, and non-approving pandemic restrictions were predictors of not-resilient outcomes in our sample. Conclusions We found similarities and differences from established predictors of resilience and identified some new ones specific to pandemics. Further investigation is warranted and could inform the design of resilience-building interventions in people with chronic diseases.

Resilience of people with a history of mental disorder during the COVID-19 pandemic: an international 2-years longitudinal prospective study

“…Older individuals had a larger likelihood of sustained resilience. These ndings are in line with previous studies, from which it emerged that the older population tends to show more resilience than younger individuals in face of sustained stressors (Bonanno & Diminich, 2013;MacLeod et al, 2016;Tarsitani et al, 2022). Older patients with a mental disorder con rm this trend.…”

“…Participants with a higher hedonism score, meaning they give pleasure and enjoyment a higher value than others, were less likely in the sustained-resilient group. This conclusion supports recent ndings of our research group in chronically medically ill, albeit diverging from the literature on the role of hedonism in other areas (Tarsitani et al, 2022). For instance, hedonism was linked to positive mental health in university students (Maercker et al, 2015) and in soldiers following military deployment (Zimmermann et al, 2014).…”

“…Among participants who reported pre-pandemic mental health disorder, those who completed at least three out of ve surveys were included in the analysis. Scores from GAD-7, PHQ-9, and PCL-5 were used to create a latent score that would give indication of a resilient response as in previous publication (Tarsitani et al, 2022).…”

“…The informed consent was obtained online from all participants via a secure web link, and participants were free to withdraw without giving an explanation at any time with no consequences. The COMET study was approved by the Ethical Review Board of the Faculty of Behavioral and Movement Sciences of VU University Amsterdam (VCWE-2020-077), and by the local Ethical Committees of all the involved institutions (see Tarsitani et al, 2022).…”

“…Although tools assessing self-reported resilience can be very helpful, in some cases a longitudinal assessment of the distress experienced relative to exposure to stressful events may be more appropriate and comprehensive. In this case, people who report less distress than others despite having experienced an identical stressful stimulus may be considered resilient (Bonanno, 2021;Bonanno et al, 2011; Galatzer-Levy et al, 2018; Harvey & Delfabbro, 2004;Tarsitani et al, 2022). It is crucial to enhance the factors that could lead to a sustained resilient response, especially in vulnerable groups (Tarsitani et al, 2022), as the COVID-19 pandemic set the speci c circumstances for a worldwide, synchronous, and long-lasting source of stress (Kunzler et al, 2023).…”