ArticleFrontiers in public health2023
Family context as a double-edged sword for psychological distress amid the COVID-19 pandemic with the mediating effect of individual fear and the moderating effect of household income.
Article in Frontiers in public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 9 citations in OpenAlex.
- Association of Perceived Xingfu With Health-Related and Socioeconomic Factors Among Hong Kong Chinese Adults: Cross-Sectional Study Using a Novel Single-Item Tool.JMIR formative research · 2025Article
- Associations of Home-Based Individual and Family Exercise with Personal and Family Well-Being Amid the COVID-19 Pandemic: A Population-Based Survey in Hong Kong.Behavioral sciences (Basel, Switzerland) · 2025Article
- The impact of mental toughness on subjective well-being among Chinese college students in the post-COVID-19 era.Frontiers in public health · 2025Article
- Fear of Cancer Recurrence and Its Associated Factors in Bladder Cancer Patients of Different Age Stages: A Cross-Sectional Study.Cancer management and research · 2025Article
- Article
- Evaluation of the Level of Psychological Distress in Construction Workers during the COVID-19 Pandemic in Southern Spain.Healthcare (Basel, Switzerland) · 2024Article
- Analysis of the Risk Factors for Negative Emotions in Patients with Esophageal Cancer During the Peri-Radiotherapy Period and Their Effects on Malnutrition.International journal of general medicine · 2023Article
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Authors and funding
8 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
Background: The COVID-19 pandemic drives psychological distress. Previous studies have mostly focused on individual determinants but overlooked family factors. The present study aimed to examine the associations of individual and family factors with psychological distress, and the mediating effect of individual fear and the moderating role of household income on the above associations. Methods: We conducted a population-based cross-sectional survey on Chinese adults in Hong Kong from February to March 2021 ( Results: Hierarchical regression showed that anti-epidemic fatigue was positively (β = 0.23, 95% CI [0.18, 0.28]) while anti-epidemic confidence was negatively (β = -0.29, 95% CI [-0.36, -0.22]) associated with psychological distress. Family members' fear of COVID-19 was positively (β = 0.11, 95% CI [0.05, 0.16]) while family well-being was negatively (β = -0.57, 95% CI [-0.63, -0.51]) associated with psychological distress. Structural equation model showed that individual fear mediated the above associations except for family well-being. Multi-group analyses showed a non-significant direct effect of anti-epidemic confidence and a slightly stronger direct effect of family well-being on psychological distress among participants with lower incomes, compared to those with higher incomes. Conclusion: We have first reported the double-edged effect of family context on psychological distress, with the positive association between family members' fear of COVID-19 and psychological distress fully mediated by individual fear and the negative association between family well-being and psychological distress moderated by income level. Future studies are warranted to investigate how the contagion of fear develops in the family and how the inequality of family resources impacts family members' mental health amid the pandemic.
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