Association between health anxiety dimensions and preventive behaviors during the COVID-19 pandemic among Japanese healthcare workers

Kentaro Nagao; Takuya Yoshiike; Ryo Okubo; Kentaro Matsui; Aoi Kawamura; Muneto Izuhara; Tomohiro Utsumi; Megumi Hazumi; Mio Shinozaki; Ayumi Tsuru; Yohei Sasaki; Kazuyoshi Takeda; Hirofumi Komaki; Hideki Oi; Yoshiharu Kim; Kenichi Kuriyama; Hidehiko Takahashi; Takeshi Miyama; Kazuyuki Nakagome

doi:10.1016/j.heliyon.2023.e22176

Association between health anxiety dimensions and preventive behaviors during the COVID-19 pandemic among Japanese healthcare workers

Heliyon. 2023 Nov 10;9(11):e22176. doi: 10.1016/j.heliyon.2023.e22176. eCollection 2023 Nov.

Authors

Kentaro Nagao^{1

2

3}, Takuya Yoshiike¹, Ryo Okubo⁴, Kentaro Matsui^{1

5}, Aoi Kawamura¹, Muneto Izuhara^{1

5}, Tomohiro Utsumi¹, Megumi Hazumi¹, Mio Shinozaki¹, Ayumi Tsuru^{1

5}, Yohei Sasaki⁴, Kazuyoshi Takeda⁴, Hirofumi Komaki⁴, Hideki Oi⁴, Yoshiharu Kim⁶, Kenichi Kuriyama¹, Hidehiko Takahashi^{1

3}, Takeshi Miyama⁷, Kazuyuki Nakagome²

Affiliations

¹ Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
² Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
³ Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
⁴ Clinical Research & Education Promotion Division, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
⁵ Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
⁶ Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.
⁷ Department of Surgery, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo, 187-8553, Japan.

Abstract

Objective: Health anxiety (HA), defined as excessive worry about having a serious medical condition, may affect preventive behaviors during the coronavirus disease 2019 (COVID-19) pandemic. We examined the distinct role of two dimensions of HA-perceived likelihood (probability dimension) and awfulness of illness (awfulness dimension)-in self-protection, as reflected in preventive behaviors during the pandemic.

Methods: Participants comprised 657 healthcare workers. Data were collected between February 24 and 26, 2021. The Short Health Anxiety Inventory determined the HA dimensions. Adherence to the government's recommendations for COVID-19 preventive behaviors was self-rated. An independent association between each HA dimension and participants' adherence to the recommendations was examined using multivariable regression.

Results: Within the analyzed sample of 560 subjects, severe HA was observed in 9.1 %. The more the participants felt awful, the less frequently they engaged in the recommended preventive behaviors (adjusted odds ratio = 0.993, 95 % confidence interval: 0.989, 0.998, p = 0.003) regardless of their profession, working position, psychological distress, sleep disturbance, and current physical diseases. However, the probability dimension was not associated with their preventive behaviors.

Conclusion: The awfulness dimension of HA could be a more sensitive marker of preventive behaviors than the probability dimension. Paying particular attention to the awfulness dimension may help optimize self-protection strategies during the COVID-19 pandemic. A two-dimensional understanding of HA may be useful for the maintenance of the healthcare system and public health as well as healthcare workers' own health.

Keywords: Awfulness; COVID-19; Health anxiety; Preventive behavior; Self-protection.