Volume 9, Issue 1 (February 2022)                   Avicenna J Neuro Psycho Physiology 2022, 9(1): 31-36 | Back to browse issues page


XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Ebadi S Z, Zamani N, Zarabian N. Relationship of Quarantine Caused by Coronavirus with Sleep Quality, Irritability, and Self-esteem of Primary School Students in District one of Karaj, Iran. Avicenna J Neuro Psycho Physiology 2022; 9 (1) :31-36
URL: http://ajnpp.umsha.ac.ir/article-1-391-en.html
1- Payame Noor Alborz University, Karaj, Iran
2- Department of Psychology, Najafabad Branch, Islamic Azad University, Najafabad, Iran , n.zamani1367@yahoo.com
3- Department of Clinical Psychology, Faculty of Medical Sciences, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
Full-Text [PDF 406 kb]   (615 Downloads)     |   Abstract (HTML)  (1126 Views)
Full-Text:   (433 Views)
Background
 
In December 2019, the release of a viral disease was reported in Wuhan, China. The cause of this disease was a new and genetically modified virus from the family of coronaviruses called coronavirus disease-2019 (COVID-19) [1]. Unfortunately, due to its very high transmission rate, the virus spread rapidly throughout the world and infected almost all countries of the world in a short time (less than four months) [2,3]. According to official reports, more than one million people in the world have been infected with the virus as of April 6, 2016, and the number of deaths caused by this virus has been reported to be more than 50,000. COVID-19, which is caused by an RNA virus, affects most of the respiratory system of people with the disease and is spreading catastrophically [4]. This virus has also infected our beloved country, Iran, like other countries in the world, and the fight against this virus is being carried out nationwide and comprehensively throughout the country. Due to the novelty of this virus and the amount of information available about the pathogenicity of COVID-19, as well as limited methods of control and treatment of this disease, currently, the most important way to deal with it is to prevent and inhibit the spread of the virus [5].
One of the most important protection ways from this disease is home quarantine. Quarantine means separating and restricting the movement of people who are potentially exposed to the contagious disease in order to ensure that they do not become ill, thereby reducing the risk of spreading the disease to others. This interpretation is different from isolation. Isolation means separating people with infectious diseases from those who are not. However, the two terms are often used interchangeably when communicating with people. The term quarantine was first used in Venice, Italy, in 1127, during the outbreak of the contagious disease of leprosy and more widely during the outbreak of the plague or the Black Death. However, 300 years later, when the plague broke out, Britain began to use quarantine properly. Quarantine was recently used during the outbreak of the COVID-19. With the outbreak, all Chinese cities were quarantined, and thousands of foreign nationals returning from China were asked to quarantine at home or in government facilities. Activities at this level have already taken place. Quarantine has already been used in all cities. They did so in China and Canada in 2003 when severe acute respiratory syndrome broke out. Moreover, many villages in West Africa were also quarantined during the 2014 Ebola outbreak [6].
For those who are quarantined, this is an unpleasant experience. Separation from loved ones, loss of freedom, uncertainty about illness, and boredom can sometimes have devastating effects. During the quarantine at the time of the outbreak of previous infectious diseases, cases, such as suicide, excessive anger, and lawsuits for quarantine were reported. The potential benefits of general compulsory quarantine must be weighed against its potential psychological harm. Successful use of quarantine as a public health measure requires us to minimize the negative effects associated with it [7]. Quarantine is significantly more likely to include burnout or fatigue, separation from others, anxiety when dealing with febrile patients, irritability, insomnia, poor concentration and indifference, impaired ability to work, and unwillingness to work.
People who were quarantined reported various negative reactions (more than 20% of fear, 18% of anger, 18% of sadness, and 10% of guilt) during quarantine because of close contact with those potentially suffering from the disease. On the other hand, there were few reports of positive emotions (5% of feeling happy and 4% of feeling relieved). Qualitative studies also revealed another range of psychological responses to quarantine, including anxiety, fear, anger, sadness, numbness, and anxiety-induced insomnia [8]. The COVID-19 pandemic has affected almost all important economic, political, social, and even military aspects of all countries in the world. In other words, the investigation of the psychological effects of this viral disease on the mental health of people at different levels of society is of great importance. Due to the pathogenicity of the virus, the rate of spread, and the percentage of deaths caused by it, the disease may affect the mental health of people at different levels of society, including patients, health care workers, families, children, students, and psychiatric patients in different ways.

Objectives

With this background in mind, in the current high-risk situation, identification of the dangers of coronavirus restrictions in this study is in response to the question of whether the quarantine caused by the coronavirus correlated with sleep quality, irritability, and self-esteem of the primary school students in District one of Karaj, Iran.

Materials and Methods

The statistical population of this correlational study included all primary school students in District one of Karaj, Iran, who are studying in the second semester of 2019-20. The total number of students in the first semester of 2019-20 was 4860, and according to Cochran's formula, the sample size was estimated at 377 cases. It should be noted that the individuals were selected from six schools by multi-stage cluster random sampling method and requested to complete the research questionnaires.

 = 377


The inclusion criteria were: (1) primary school students, (2) students of District one of Karaj, (3) students who have been studying at schools in District one of Karaj since the beginning of the year and did not transfer in the middle of the year, and (4) students who did not repeat a year twice. On the other hand, those who relocated in the middle of the year, and the students with relocated schools were excluded from the study.
The data collection tools included:

Coronavirus Quarantine Questionnaire
This questionnaire was developed and standardized by the World Health Organization in 2020 and included the amount of attendance at home, do online shopping from home, and meeting individuals and homes' needs in the days of the epidemic [9]. The coronavirus quarantine questionnaire has acceptable validity and reliability. The Cronbach's alpha coefficient was reported by the World Health Organization to be 0.88 for the overall test score. Ebrahimi, Zamani, and Haghi [10] reported Cronbach's alpha of 0.83 and retest coefficient of 0.88 after three weeks.

Pittsburgh Sleep Quality Questionnaire
This questionnaire was developed in 1989 by Boyce et al. [11] and basically has nine items; however, since question five itself contains 10 sub-items, the whole questionnaire contains 19 items that are rated on a 4-point Likert scale from 0 to 3 [12].

Crick, Hitan, Malkova, and Bruce Irritability Questionnaire
This questionnaire consists of 21 items and is rated on a Likert scale from 0 to 3. Brahmand and Haji have standardized this scale in Iran [13]. Its reliability by Cronbach's alpha coefficient in the original version for the total test equals 0.90, and between the halves of the test is estimated at 0.78. It is worth mentioning that its validity was obtained at 0.82 after two weeks. The reliability of the translated version was also obtained by Cronbach's alpha method of 0.79, which indicates the validity of this scale and its scientific usability.

Coopersmith Self-Esteem Questionnaire
The Coopersmith Self-Esteem Questionnaire consists of five topics, including homework, social relationships, family, self, and future; moreover, it has four subscales, namely general self-esteem, social self-esteem (peers), family self-esteem (parents), and academic self-esteem (educational). This questionnaire has 58 two-choice questions with "yes" and "no" options that each person chooses one of the options according to his/her situation. Since the test has a scholastic subscale, it can only be used for students. This list refers to two mental aspects and obvious behaviors of self-regard [14]. This questionnaire has acceptable validity and reliability, and Cronbach's alpha coefficient was reported to be 0.88 for the overall test. Furthermore, regarding the validity of the total score of the test, the sub-scale of annoyance in the Eysenck personality test, the validity of negative and significant divergence, and the extroversion subscale, it has shown significant positive convergence validity. Rosenberg [12] reported a retest coefficient of 0.88 after five weeks and 0.70 after three years.

The results of the study by Bayat and Yaghoubi [16], which was conducted in Abhar, Iran, showed acceptable validity and reliability for Coopersmith self-esteem list. Cronbach's alpha in this study was calculated to be 0.796. In this study, the validity coefficient was calculated at 0.792 using the Eysenck test. In addition, to examine the construct validity, factor analysis was performed by the principal component analysis method, and the results showed that the list is of five saturation scales, which explain a total of 21% of the total variance of the variables. The reliability of the self-esteem questionnaire in the present study was 84%, which indicates high reliability. To analyze the results, initially, by calculating the Pearson correlation coefficient, the relationships among the main variables of the research, as well as subscales were identified. Subsequently, simultaneous multiple regression analysis was performed to explain and predict dependent variables (sleep quality, irritability, self-esteem) based on the independent variable (quarantine due to coronavirus). In the continuation of this section, using independent t-test, Pearson and Spearman correlation coefficients were employed to determine the relationship of demographic characteristics with sleep quality, irritability, and self-esteem.

Results

According to the results obtained from the demographic characteristics of 377 primary school students (first to sixth grades), 227 (60%) cases were male. The mean age of the participants was obtained at 10±7 years (age range: 7-12 years). Regarding the level of education, about 40%, 32%, 16%, and 11% of the subjects were in the fifth, first and second, third and fourth, as well as sixth grades of primary school, respectively.
The savings of about 24% of the surveyed people were between 700,000 and 900,000 Tomans. Moreover, 30% of the participants reported savings of about higher than one million Tomans, and about 19% of savings were between 300,000 and 500,000 Tomans; furthermore, savings of between 500,000 and 700,000 thousand Tomans were reported by 10% of the cases. It is worth mentioning that 17% of people did not answer this question.

Table 1. Pearson's correlation coefficient to investigate the relationship between quarantine and sleep quality
Total sleep quality Daily functional disorders Sleeping pills Sleep disorders Duration and amount of sleep efficiency Delay in falling asleep Mental quality of sleep Variables
0.405 0.312 0.346 0.362 0.394 0.364 0.151 Quarantine caused by the virus


Table 2. Pearson correlation coefficient to investigate the relationship of quarantine with irritability and its components
Total irritability score Anxiety /arousal Incompatibility and perseverance Decentralize /act impulsively Dissatisfaction and boredom Hostility/haste Variables
0.324 0.303 0.99 0.285 0.069 0.254 Quarantine


Table 3. Pearson's correlation coefficient to investigate the relationship of quarantine with self-esteem and its components
Total Self-esteem Family self-esteem (parents) Public self-esteem Academic self-esteem (educational) Social self-esteem (peers) Variables
0.391 0.306 0.099 0.058 0.254 Quarantine

 
According to the results of descriptive statistics, sleep quality has six components, and 19 questions have been used to measure each component. Among the components of sleep quality, "mental quality of sleep" with a mean score of 58.14 was the strongest, and "use of sleep drugs" with a mean score of 53 was the weakest component of this item. The mean±SD of descriptive statistics of quarantine scores was estimated at 414.89±54.19. The irritability variable has five dimensions, and the highest mean score belongs to the anxiety/arousal dimension with a mean score of 17.81. On the other hand, the lowest mean score (8.84) belongs to the dissatisfaction and impatience dimension, and finally, the self-esteem variable has three dimensions. Among the dimensions of self-esteem, "social self-esteem (peers)" with a mean weight of 3.06 (based on coefficients) was the strongest, and "general self-esteem" with a mean weight of 3.02 was the weakest dimension of the self-esteem in the subjects.
According to Table 1, it can be observed that the Pearson correlation coefficient shows a positive and significant relationship of about 0.41 between quarantine and total sleep quality (n=377, r=0.405, P<0.01). Therefore, it can be said that a longer time of quarantine leads to the higher total quality of their sleep. Therefore, there is a significant relationship between quarantine and sleep quality. According to Table 2, it can be observed that the Pearson correlation coefficient shows a positive and significant relationship of about 0.33 between quarantine and total irritability (n=377, r=0.334, P<0.01). Therefore, it can be said that the longer time of quarantine results in higher levels of total irritability, and there is a positive and significant relationship between quarantine and all components of irritability, except for dissatisfaction and impatience, as well as incompatibility and perseverance (hostility/haste, lack of focus/impulses to act, and anxiety/arousal) (P<0.05).
Furthermore, the result indicates that a longer time of quarantine in the students leads to higher levels of hostility/haste, lack of focus/impulse, and anxiety/arousal. Among the irritability components, quarantine has the strongest relationship with anxiety/arousal (0.30), and the weakest relationship with dissatisfaction and impatience (0.07).
According to the results of Table 3, it can be noted that the Pearson correlation coefficient shows a positive and significant relationship of about 0.39 between quarantine and total self-esteem (n=377, r=0.391, P<0.01). Therefore, it can be said that a longer time of quarantine results in higher levels of total self-esteem. Moreover, there is a positive and significant relationship between quarantine and all components of self-esteem, except for academic (educational) self-esteem (P<0.05). Accordingly, a longer time of quarantine in the students leads to lower levels of educational self-esteem. Among the components of self-esteem, quarantine has the strongest and weakest relationships with family self-esteem (parents) (0.30) and academic self-esteem (educational) (0.06), respectively.

Discussion

The global pandemic of COVID-19 has affected and paralyzed almost all important economic, political, social, and even military aspects of all countries worldwide. The investigation of the psychological effects of this viral disease on the mental health of people at different levels of society is of great importance. Due to the pathogenicity of the virus, the rate of spread, and the percentage of deaths caused by it, the disease may affect the mental health of people at different levels of society, including patients, health care workers, families, children, students, and psychiatric patients in different ways. Therefore, in the current high-risk situation, identification of the dangers of coronavirus restrictions in this study is in response to the question of whether the quarantine caused by the coronavirus correlated with sleep quality, irritability, and self-esteem of primary school students in District one of Karaj, Iran.
The results of this study were consistent with the findings of studies performed by Ahmadi, Johari, Adnan, Aftab, and Zafar et al. [17]. It was revealed that people who quarantined properly had a higher sleep quality. This can be explained by the fact that breaking the quarantine causes anxiety and worry, and consequently, leads to a decrease in the quality of sleep in people. Therefore, people who observed quarantine properly had a higher quality of sleep. The results of this study were also in line with the findings of a study conducted by Yang, Li, Zhang, Zhang, Cheung, and Xiang [18]; however, the difference is that the aforementioned study was conducted on different groups. In explaining these results, it can be said that quarantine leads to restrictions, such as leaving home; accordingly, children are alone during this period and do not have much fun at home. Sometimes, the only entertainment is playing with smartphones and watching TV, which leads to fatigue and increased impulsivity. In addition, there is a positive and significant relationship between quarantine and all components of self-esteem, except for academic self-esteem, which showed that a longer time of quarantine among students led to higher levels of their academic self-esteem. Among the components of self-esteem, quarantine has the strongest and weakest relationships with family self-esteem (parents) and academic self-esteem (educational), respectively.
Zhou, Snoswell, Harding, Bambling, Edirippulige, and Bai [19] in a study entitled "Understanding Corona Virus 2019 and Corona Virus Disease Based on Evidence" concluded that the complications of Coronavirus 2019 in psychological symptoms are such that all individuals and survivors after illness require specialized counseling in the field of irritability and self-esteem since excessive presence at home leads to self-morbidity and apparent self-criticism that affects self-esteem.

Limitations of the study
Regarding the limitations of this study, one can refer to the lack of similar studies, refusal to transfer information by the respondent, and resistance to answering questions online. Respondents’ patience in answering the questions is one of the other limitations that the indirect researcher faces in such a way that the respondent does not answer some of the questions. Lack of cooperation of individuals, incorrect answers, as well as lack of necessary budget to carry out and advance the research work are other limitations that the researchers face. However, practical suggestions have been provided to reduce the limitations.

Conclusions

The results showed the relationship of quarantine caused by Coronavirus with sleep quality, irritability, and self-esteem of primary school students in District one of Karaj, Iran.

Compliance with ethical guidelines
All ethical principles were adhered to in the present study

Acknowledgments
The authors would like to thank the participants, who greatly cooperated in this study. 

AuthorsΚΌ contributions
???
Funding/Support
This study received no specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflicts of Interest
The authors declare that they have no conflict of interest.

References
  1. Adhikari SP, Meng S, Wu YJ, Mao YP, Ye R, Wang QZ, et al. Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious Diseases of Poverty. 2020;9(1):1-12. [DOI:10.1186/s40249-020-00646-x] [PMID]
  2. Ahmed MA, Jouhar R, Ahmed N, Adnan S, Aftab M, Zafar MS. Fear and Practice Modifications among Dentists to Combat Novel Coronavirus Disease (COVID-19) Outbreak. International Journal of Environmental Research and Public Health. 2020; 17(8): 2821. [DOI:10.3390/ijerph17082821] [PMID]
  3. Ahmadi-Tahor-Soltani M, Taherabadi S, Rahnejat AM, Taghva A, Shahed-Haghghadam H, Donyavi, V. An evaluation of providing psychological interventions during coronavirus disease (COVID- 19): a narrative review. EBNESINA. 2020; 22(1):8-16. [DOI:  10.22034/22.1.8]
  4. Blake H, Bermingham F, Johnson G, Tabner A. Mitigating the Psychological Impact of COVID-19 on Healthcare Workers: A Digital Learning Package. International Journal of Environmental Research and Public Health. 2020; 17(9):2997. [DOI:10.3390/ijerph17092997.] [PMID]
  5. Cao W, Fang Z, Hou G, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry research. 2020; 11(2):95-106. [DOI: 10.1016/j.psychres.2020.112934]
  6. Holmes EA, O'Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. 2020; 366(20): 30161-8. [DOI:10.1016/S2215- 366(20)30168-1.]
  7. Huang J, Han M, Luo T, Ren A, Zhou X. Mental health survey of 230 medical staff in a tertiary infectious disease hospital for COVID-19. Chinese Journal of Industrial Hygiene and Occupational Diseases. 2020; 38(3):192-195. [DOI: 10.3760/cma.j.cn121094-20200219-00063] [PMID]
  8. Ianiro G, Mullish BH, Kelly CR, Sokol H, Kassam Z, Ng S, et al. Screening of faecal microbiota transplant donors during the COVID-19 outbreak: suggestions for urgent updates from an international expert panel. The Lancet Gastroenterology & Hepatology. 2020; 5(5): 430-432 [DOI:10.1016/S2468- 1253(20)30082-0.] [PMID]
  9. Li S, Wang Y, Xue J, Zhao N, Zhu T. The impact of COVID-19 epidemic declaration on psychological consequences: a study on active Weibo users. International journal of environmental research and public health. 2020; 17(6):2032. [DOI:10.3390/ijerph17062032.]
  10. Liu S, Yang L, Zhang C, Xiang Y, Liu Z, Hu S, et al. Online mental health services in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4):e17-e8. [DOI:10.1016/S2215- 0366(20)30077-8.]
  11. Boyce WH. Cumulative number of reported probable cases of COVID. 2020.
  12. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International journal of environmental research
    and public health. 2020; 17(5):1729.
    [DOI: 10.3390/ijerph17051729.] [PMID]
  13.  Yang L, Wu D, Hou Y, Wang X, Dai N, Wang G, et al. Analysis of psychological state and clinical psychological intervention model of patients with COVID-19. MedRxiv; 2020:1-8. [DOI:10.1101/2020.03.22.20040899]
  14. Sun L, Sun Z, Wu L, Zhu Z, Zhang F, Shang Z, et al . Prevalence and Risk Factors of Acute Posttraumatic Stress Symptoms during the COVID- 19 Outbreak in Wuhan, China. Journal of Affective Disorders, 2021;238:123-129 . [DOI:10.1101/2020.03.06.20032425]
  15. Xiao H , Zhang Y ,  Kong D ,  Li S , Yang N . Social capital and sleep quality in individuals who self-isolated for 14 days during the coronavirus disease 2019 (COVID-19) outbreak in January 2020 in China. Medical science monitor: international medical journal of experimental and clinical research. 2020;
    26:e923921-1.
    [DOI:10.12659/MSM.923921.]
  16. Xiang Y, Wen L, Zhang Q, Jin Y, Rao WW, Zeng LN. Timely research papers about COVID-19 in China. The
    Lancet. 2020; 395(10225): 684-5.
    [DOI:10.1016/S0140-6736(20)30375-5]
  17. Xiao C.  A Novel Approach of Consultation on 2019 Novel Coronavirus (COVID-19)-Related Psychological and Mental Problems: Structured Letter Therapy. Psychiatry investigation. 2020; 17(2):175. [DOI:10.30773/pi.2020.0047.] [PMID]
  18. Yang Y, Li W, Zhang Q, Zhang L, Cheung T, Xiang Y-T. Mental health services for older adults in China during the COVID-19 outbreak. The Lancet Psychiatry. 2020; 7(4):e19. [DOI:10.1016/S2215-0366(20)30079-1]
  19. Zhou X, Snoswell CL, Harding LE, Bambling M, Edirippulige S, Bai X, et al. The role of telehealth in reducing the mental health burden from COVID-19. Telemedicine and e-Health. 2020; 26(4):377-9. [DOI:10.1089/tmj.2020.0068]

Article Type: Research Article | Subject: Clinical Psychology
Received: 2021/06/19 | Accepted: 2021/09/15 | Published: 2022/02/25

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2024 CC BY 4.0 | Avicenna Journal of Neuro Psycho Physiology

Designed & Developed by : Yektaweb