Journal of Preventive Medicine

Extended Abstract
Introduction
The coronavirus disease 2019 (COVID-19) started as an epidemic in China in December 2019. This virus has spread rapidly worldwide and as a result, it was recognized as an epidemic by the World Health Organization in March 2020. This disease is known as a great threat to physical and mental health and it affects the quality of life (QoL) of people by creating many psychological problems. Long quarantine period, fear of disease, mental fatigue, insufficient information, financial loss, loss of freedom, uncertainty about the condition of the disease, uncertainty of the time to control the disease, and the seriousness of the risk are among the stress factors that can affect the QoL of people during this pandemic. On the other hand, in the COVID-19 pandemic, health anxiety has increased in terms of frequency and intensity than before. In this situation, people with high health anxiety are prone to wrong and harmful perceptions of their physical changes and use all these changes as proof that they are infected with an infectious disease, which leads to maladaptive coping behaviors, such as excessive hand washing, social withdrawal, and shopping with panic. Accordingly, it is very important to identify the psychological effects of this disease on the mental health of people and its relationship with the QoL. Therefore, the present study was conducted to investigate the relationship between perceived stress and health anxiety, and QoL during the COVID-19 pandemic.
Methods
The current correlational descriptive research was done in 2021 on the residents of Isfahan over 16 years of age. In this study, 320 people were selected by the available sampling method. The inclusion criteria were: 1) being literate, 2) having access to the Internet to answer questions, 3) not suffering from psychological disorders, 4) having at least 16 years of age, 5) living in Isfahan, and 6) willingness to participate in the research. Exclusion criteria included people suffering from psychological disorders and unwillingness to participate in the research. In order to protect the health of the participants, the data were collected online using messaging platforms, such as WhatsApp and Telegram channels. The link to the questionnaire was made available to the participants through various online groups and the participants who received the link were requested to send it to the people they knew. Informed written consent was obtained from the people who participated in this study. Demographic questionnaire (information, such as gender, marital status, education level, age, employment status, smoking status, and suffering from certain underlying diseases), the Short Health Anxiety Questionnaire (SHAI) by Salkovskis et al., Perceived Stress Scale (PSS) by Cohen et al., and World Health Organization’s QoL Brief Questionnaire (WHOQoL-BREF) were used to collect data. The data were analyzed using SPSS v. 24 software. For descriptive data, frequency, percentage, and minimum and maximum values were used, and for inferential data, Pearson’s correlation coefficient and regression analysis were used. A significance level of 95% (P<0.05) was considered.
Results
The results showed that 18.1% (58) of the participants in the research were male and 81.9% (262) were female. More than half of the participants (69.1%) were married and the rest were single (29.1%), widowed (0.6%), or divorced (1.2%). The majority of the participants (42.8%) had a bachelor’s degree. 36.6% of the participants were housewives. Also, 92.6% of the participants did not use any tobacco products. Only 6.6% of the participants were doctors, nurses, or members of the healthcare staff and 12.2% of the participants had underlying diseases. The average age of the participants in the research was 36.48 years (SD=11.25). The mean and standard deviation of the research variables were as follows: perceived stress 27.72 (8.65), perceived helplessness: 14.09 (5.24), perceived self-efficacy: 14.37 (4.66), health anxiety: 14.12 (7.74), probability of contracting the disease: 21.12 (6.46), negative consequences of contracting the disease: 1.91 (2.004), QoL: 26.87 (15.74), physical health: 24.58 (4.89), mental health: 26.19 (42.4), social relations: 9.96 (2.54) and environmental health: 26.22 ( 5.16). The results of Pearson correlation analysis showed a significant negative relationship between perceived helplessness (r=-0.606), perceived stress (r=-0.706), probability of contracting the disease (r=-0.278), negative consequences of contracting illness (r=0.528), and health anxiety (r=0.369) with QoL (P<0.01). Also, there was a significant positive relationship between perceived self-efficacy and QoL (r=0.628, P<0.01). In addition, the results of the regression analysis showed that perceived self-efficacy, negative consequences of illness, and perceived helplessness can significantly predict 57.5% of the variance of QoL (P<0.01). The results indicated that each of these variables can explain the QoL with beta coefficients of 0.389, -0.3, and -0.284, respectively.
Discussion
The results of the study showed that the spread of the coronavirus has changed people’s living conditions and has had destructive psychological effects, such as stress and health anxiety.
Ethical Considerations
Compliance with ethical guidelines
Ethical approval was received for this study from the Ethics Committee of the Hormozgan University of Medical Sciences (IR.HUMS.REC.1399.439). 
Funding
This project is funded by a research grant from the Hormozgan University of Medical Sciences. The funding body (HUMS) didn't have any role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.
Authors' contributions
Study design, data collection, statistical analysis and article writing: Atefeh Homayouni; Study design, cooperation in writing and revising the article: Zahra Hosseini.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors are grateful for the financial support of Hormozgan University of Medical Sciences as well as all the participants in this research.

 

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