Psychological distress during COVID-19 pandemic in low-income and middle-income countries: a cross-sectional study of older persons in Thailand

Abstract

ObjectiveThe COVID-19 situation in Thailand was controlled with various social measures. Much of the information covered in the media and in studies focused on the public health and economic aspects of the pandemic. This study aimed to explore the psychological well-being of older people, which is important especially in an ageing society categorised as low income or middle income due to the limits of economic and healthcare resources.SettingThe impact of COVID-19 on older persons in Thailand, an online survey, taken across nine provinces within the five regions of the country.ParticipantsInformation was collected from 1230 adults aged at least 60 years old.If an older person was illiterate, unable to access the internet or had a disability preventing them from responding to the survey, an intermediary residing in the community conducted the survey interview.Primary and secondary outcome measuresThe analysis focused on the worries of older adults and the factors associated with psychological distress experienced during the pandemic using logistic regression analysis.ResultsThe majority of people aged at least 60 years old experienced psychological distress during COVID-19. Employment loss (OR 1.08, 95% CI 0.78 to 1.38), inadequate income (OR 1.77, 95% CI 1.28 to 2.44) and debt incursion (OR 2.74, 95% CI 1.57 to 4.80) were detrimental to psychological well-being. The negative changes in the perception of their health status (OR 1.92, 95% CI 1.23 to 2.99) and decreased life satisfaction (OR 1.49, 95% CI 0.45 to 1.87) also weighed on older Thais. The protective factors for psychological well-being were residing in rural areas (OR 0.46, 95% CI 0.35 to 0.61) and being married (OR 0.75, 95% CI 0.55 to 1.01).ConclusionObserving the concerns of the older population is important for introducing policies that can alleviate their precarious financial and health statuses.

The impact of COVID-19 non-pharmaceutical interventions on the lived experiences of people living in Thailand, Malaysia, Italy and the United Kingdom: A cross-country qualitative study

“…Furthermore, lower rates of literacy and technological skills among the older population are likely to create additional barriers for maintaining social contact, and accessing healthcare and social support services remotely when NPIs like movement restrictions are in place [75,76]. Challenges facing older people during COVID-19 lockdowns are likely to be exacerbated for those living in LMICs, like Malaysia [75] and Thailand [77], where older people commonly live in multi-generational households (thereby increasing their risks of COVID-19 exposure), and where greater health system level barriers exist for accessing age-appropriate services and support [76,78]. Governments should attend to the specific challenges facing older populations, such as by adopting strategies to tackle isolation and loneliness, such as the UK's "support bubble" intervention introduced in September 2020 [79] to support health and wellbeing of older people who live alone in light of ongoing pandemic restrictions.…”

Poverty, noncommunicable diseases, and perceived health risks among older adults during the COVID‐19 pandemic in urban Thailand

“…Based on the present analysis, being 70 years old or older and having a metabolic risk factor were associated with worry about worsening health status. At the onset of the pandemic, worsening health was the main concern of older individuals in Thailand (Pothisiri & Vicerra, 2021 ). Disruptions to social life, including the capacity to attend to medical needs, were noted as a strain experienced in general by this age group (Le Couteur et al, 2020 ).…”

“…Higher educational attainment and higher income level were differently associated with the worry of being infected with COVID‐19 and worries concerning health status and healthcare access. Shortcomings in income and loss of employment were found to be associated with psychological distress among older adults (Pothisiri & Vicerra, 2021 ). Maintaining sufficient earnings is important and may result in people continuing to work despite the pandemic, thereby increasing their exposure to the virus.…”

“…The current study is different from existing studies in that it focuses on later‐life adults who have compounded vulnerabilities, particularly those living in poverty in urban areas. Although urban populations were perceived to have better access to health services in Thailand before the pandemic (Aekplakorn et al, 2011 ; Quashie & Pothisiri, 2019 ), notable challenges already existed in relation to access to health information and expenditures for basic needs such as food and housing at the onset of the pandemic (Pothisiri & Vicerra, 2021 ; Vicerra, 2021 ). Thus, the aim of this study was to further understand the confluence of urban poverty, NCDs, and advanced age to determine the concerns of people with multiple vulnerabilities.…”

Do University Students Adhere to WHO Guidelines on Proper Use of Face Masks during the COVID-19 Pandemic?—Analysis and Comparison of Medical and Non-Medical Students

“…Until now, hundreds of articles in worldwide journals have been published using this methodology [7][8][9][10][11]. Moreover, with the COVID-19 pandemic, researchers have been using online questionnaires even more frequently due to contact restrictions, lack of face-to-face contact and no possibility to travel [12][13][14][15][16][17][18]. A similar methodology was employed by Machida et al [19] in their paper about the incorrect use of face masks during the COVID-19 pandemic.…”