Social support mediates the associations of Information and Communication Technology use with mental health in Chinese COVID-19 patients during hospital quarantine.

BACKGROUND

Information and communication technology (ICT) use can be a double-edged sword for mental health. This study aimed to examine whether different types of ICT use were diversely associated with mental health outcomes in hospital-quarantined patients during the COVID-19 pandemic, and to assess whether social support mediated these associations.

METHODS

This cross-sectional study involved hospital-quarantined COVID-19 patients from 10 March to 28 April 2022 in Shenzhen, China. Patients reported their ICT use, including online entertainment, contacting family/friends, reading online news, working/studying, using social media platforms, and online shopping, as well as social support and mental health. To facilitate early detection and identify potential ICT measures for supporting quarantined patients’ mental health, we applied lower cutoff scores to classify mild-or-greater mental health symptoms as outcomes, including depression (Patient Health Questionnaire-9 score ≥ 5), anxiety (Generalized Anxiety Disorder Scale-7 ≥ 5), PTSD (PTSD Checklist-Civilian version score ≥ 38), somatization symptoms (Self-reported Somatic Symptom Scale-China score ≥ 30), and insomnia (Insomnia Severity Index score ≥ 8). The associations of ICT use with mental symptoms were estimated using adjusted prevalence ratios (aPRs) by Poisson regressions, adjusting for sex, age, education, marital status, monthly household income, and household registration. Sobel-Goodman Mediation tests were used to analyze the mediating effects of social support.

RESULTS

Among the 217 patients (female 48.9%, 25–54 years 63.1%), over half had depression (56.3%), insomnia (54.5%), and anxiety (50.5%), followed by somatization symptoms (35.4%) and post-traumatic stress disorder (PTSD, 18.0%). The majority used ICT for entertainment (77.4%) and contacting family/friends (74.2%). Those using ICT for contacting family/friends, working/studying, and online shopping had less depression, anxiety, PTSD, or somatization symptoms (aPRs 0.52–0.78, all P ≤ 0.04). Social support mediated 24.5–42.1% of the associations of using ICT for contacting family/friends with depression, anxiety, somatization symptoms, and PTSD, and 43.4–52.4% of the associations of working/learning with them.

CONCLUSIONS

This study shows that the different ICT use varies in their associations with mental symptoms during quarantine by their motivation. Social support partially mediates the associations of contacting family/friends and working/studying with mental symptoms, emphasizing supportive digital environments to strengthen social connectedness and mental health for quarantined patients.