ORIGINAL ARTICLE
Loneliness and quality of life: Perceived online and offline social support among Sub-Saharan African students in China during the COVID-19 lockdowns
 
More details
Hide details
1
School of Nursing and Health, Zhengzhou University, Zhengzhou, CHINA
 
2
Nursing and Midwifery Training College, Twifo Praso, Central Region, GHANA
 
3
School of International Education, Southern Medical University, Guangzhou, CHINA
 
4
Department of Social Work, Chinese University of Hong Kong, Shatin, HONG KONG
 
5
Department of Social and Behavioral Sciences, College of Liberal Art and Social Sciences, City University of Hong Kong, Kowloon, HONG KONG
 
6
Department of Demography, College for Health, Community and Policy, The University of Texas, San Antonio, TX, USA
 
 
Publication date: 2022-10-15
 
 
Electron J Gen Med 2022;19(6):em419
 
KEYWORDS
ABSTRACT
Objective/background:
The COVID-19 pandemic disrupted education globally, triggering fear and uncertainties for students. However, there is currently no research evidence to document the loneliness experience of Sub-Saharan African (SSA) students in China and how social support influenced their quality of life (QoL). This study explored the effect of COVID-19-induced loneliness and social support on the QoL of SSA students in China.

Method:
The study adopted an institutional-based cross-sectional survey through an online questionnaire on social media platforms to investigate the QoL of SSA students in Chinese universities. Pearson correlation matrix and regression analysis were conducted to validate the association of loneliness, social support (online and offline), and socio-demographic attributes on the student’s QoL.

Result:
In the population of 358 SSA students appraised in the study, loneliness experience was negatively associated with QoL. Online social support and offline social support were positively associated with QoL. The linear regression shows that loneliness, social support, and socio-demographic attributes explain 25.7% (psychological health), 26.6% (physical health), 24.9% (environmental health), and 30.3% (social relation) of the variance in the QoL domains. By evaluating the EUROHIS subjective QoL, loneliness independently accounts for 24.5% of the variance in the subjective QoL of the SSA students examined in the study (model 1). In comparison, the added effects of social supports and socio-demographic attributes on model 3 explained 32% of the subjective QoL.

Conclusion:
It is strongly recommended that loneliness eradication programs be implemented in these universities among SSA students who experience loneliness that negates their QoL. Interventions should focus on how these students can integrate and build social networks (online and offline) to improve social interaction and support for better QoL.

REFERENCES (68)
1.
Tian L, Liu NC. Inward international students in China and their contributions to global common goods. High Educ. 2021;81(2):197-217. https://doi.org/10.1007/s10734... PMid:32205895 PMCid:PMC7088380.
 
2.
Akintunde TY, Tassang AE, Okeke M, Isangha SO, Musa TH. Perceived vaccine efficacy, willingness to pay for COVID-19 vaccine and associated determinants among foreign migrants in China. Electron J Gen Med. 2022;19(3):em376. https://doi.org/10.29333/ejgm/....
 
3.
Ecochard S, Fotheringham J. International students’ unique challenges–Why understanding international transitions to higher education matters. JPAAP. 2017;5(2):100-8. https://doi.org/10.14297/jpaap....
 
4.
Ennis E, McLafferty M, Murray E, et al. Readiness to change and barriers to treatment seeking in college students with a mental disorder. J Affect Disord. 2019;252:428-34. https://doi.org/10.1016/j.jad.... PMid:31003112.
 
5.
Zivin K, Eisenberg D, Gollust SE, Golberstein E. Persistence of mental health problems and needs in a college student population. J Affect Disord. 2009;117(3):180-5. https://doi.org/10.1016/j.jad.... PMid:19178949.
 
6.
Mori SC. Addressing the mental health concerns of international students. J Couns Dev. 2000;78(2):137-44. https://doi.org/10.1002/j.1556....
 
7.
Oyeniran OI, Ajagbe AO, Onigbinde OA, Chia T, Yinka AT. Educational transition amid COVID-19 outbreak in Africa: Challenges and opportunities for medical education. Int J Basic Appl Med. 2021;6(3):76-9. https://doi.org/10.34172/ijbsm....
 
8.
Akintunde TY, Chen S, Musa TH, et al. Tracking the progress in COVID-19 and vaccine safety research–a comprehensive bibliometric analysis of publications indexed in Scopus database. Hum Vaccin Immunother. 2021;17(11):3887-97. https://doi.org/10.1080/216455... PMid:34613876 PMCid:PMC8828093.
 
9.
Sayibu M, Chu J, Akintunde TY, Rufai OH, Amosun TS, George-Ufot G. Environmental conditions, mobile digital culture, mobile usability, knowledge of app in COVID-19 risk mitigation: A structural equation model analysis. Smart Health. 2022;25:100286. https://doi.org/10.1016/j.smhl... PMid:35600252 PMCid:PMC9110057.
 
10.
Akintunde TY, Musa TH, Musa HH, et al. Bibliometric analysis of global scientific literature on effects of COVID‐19 pandemic on mental health. Asian J Psychiatr. 2021;63:102753. https://doi.org/10.1016/j.ajp.... PMid:34280888.
 
11.
Helmy M, Akintunde TY, Musa TH, et al. Global research evidence on COVID-19 and anxiety: A bibliometric analysis. Arab Gulf J Sci Res. 2021;39(Special Issue):60-78. https://doi.org/10.51758/agjsr....
 
12.
Lobos-Rivera M, Chacon-Andrade ER, Cervigni M, et al. Psychological factors related to fear of COVID-19 in the general salvadoran population. Electron J Gen Med. 2022;19(2):em351. https://doi.org/10.29333/ejgm/....
 
13.
Mackolil J, Mackolil J. Addressing psychosocial problems associated with the COVID-19 lockdown. Asian J Psychiatr. 2020;51:102156. https://doi.org/10.1016/j.ajp.... PMid:32413617 PMCid:PMC7207101.
 
14.
Tandon R. The COVID-19 pandemic, personal reflections on editorial responsibility. Asian J Psychiatr. 2020;50:102100. https://doi.org/10.1016/j.ajp.... PMid:32354694 PMCid:PMC7165287.
 
15.
Cattan M, Newell C, Bond J, White M. Alleviating social isolation and loneliness among older people. Int J Ment Health Promot. 2003;5(3):20-30. https://doi.org/10.1080/146237....
 
16.
Lyyra N, Välimaa R, Tynjälä J. Loneliness and subjective health complaints among school-aged children. Scand J Public Health. 2018;46(20_suppl):87-93. https://doi.org/10.1177/140349... PMid:29552967.
 
17.
Bogaerts S, Vanheule S, Desmet M. Feelings of subjective emotional loneliness: An exploration of attachment. Soc Behav Pers. 2006;34(7):797-812. https://doi.org/10.2224/sbp.20....
 
18.
Hyland P, Shevlin M, Cloitre M, et al. Quality not quantity: loneliness subtypes, psychological trauma, and mental health in the US adult population. Soc Psychiatry Psychiatr Epidemiol. 2019;54(9):1089-99. https://doi.org/10.1007/s00127... PMid:30293176.
 
19.
Chukwuorji JC, Amazue LO, Ekeh OH. Loneliness and psychological health of orthopaedic patients’ caregivers: Does gender make a difference? Psychol Health Med. 2017;22(4):501-506. https://doi.org/10.1080/135485... PMid:28114810.
 
20.
Karakose T, Yirci R, Uygun H, Ozdemir TY. Relationship between high school students’ Facebook addiction and loneliness status. EURASIA J Math Sci Tech Ed. 2016;12(9):2419-29. https://doi.org/10.12973/euras....
 
21.
Osman E, Cirak NS. Exploring the loneliness and internet addiction level of college students based on demographic variables. Cont Ed Technology. 2019;10(2):156-72. https://doi.org/10.30935/cet.5....
 
22.
Erzen E, Cikrikci O. The effect of loneliness on depression: A meta-analysis. Int J Soc Psychiatry. 2018;64(5):427-35. https://doi.org/10.1177/002076... PMid:29792097.
 
23.
Sündermann O, Onwumere J, Kane F, Morgan C, Kuipers E. Social networks and support in first-episode psychosis: Exploring the role of loneliness and anxiety. Soc Psychiatry Psychiatr Epidemiol. 2014;49(3):359-66. https://doi.org/10.1007/s00127... PMid:23955376 PMCid:PMC4081600.
 
24.
Cacioppo JT, Hughes ME, Waite LJ, Hawkley LC, Thisted RA. Loneliness as a specific risk factor for depressive symptoms: Cross-sectional and longitudinal analyses. Psychol Aging. 2006;21(1):140. https://doi.org/10.1037/0882-7... PMid:16594799.
 
25.
Richard A, Rohrmann S, Vandeleur CL, Schmid M, Barth J, Eichholzer M. Loneliness is adversely associated with physical and mental health and lifestyle factors: Results from a Swiss national survey. PloS One. 2017;12(7):e0181442. https://doi.org/10.1371/journa... PMid:28715478 PMCid:PMC5513556.
 
26.
Christiansen J, Qualter P, Friies K, et al. Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Perspect Public Health. 2021;141(4):226-236. https://doi.org/10.1177/175791... PMid:34148462.
 
27.
Seifert N, Seddig D, Eckhard J. Does social isolation affect physical and mental health? A test of the social causation hypothesis using dynamic panel models with fixed effects. Aging Ment Health. 2022;26(7):1353-67. https://doi.org/10.1080/136078... PMid:34551635.
 
28.
WHOQOL. World Health Organization quality of life assessment (WHOQOL): Development and general psychometric properties. Soc Sci Med. 1998;46(12):1569-85. https://doi.org/10.1016/S0277-....
 
29.
Kim C-J, Park H-R, Schlenk EA, Kang S-W, Seo EJ. The moderating role of acculturation mode on the relationship between depressive symptoms and health-related quality of life among international students in Korea. Arch Psychiatr Nurs. 2019;33(6):192-7. https://doi.org/10.1016/j.apnu... PMid:31753227.
 
30.
Su Z, McDonnell D, Shi F, et al. Chinese international students in the United States: The interplay of students’ acculturative stress, academic standing, and quality of life. Front Psychol. 2021;12:625863. https://doi.org/10.3389/fpsyg.... PMid:34531778 PMCid:PMC8439167.
 
31.
Adedeji A, Akintunde TY, Idemudia ES, Ibrahim E, Metzner F. Trust, sociability, and quality of life of Sub-Saharan African migrants in Germany. Front Sociol. 2021;6:741971. https://doi.org/10.3389/fsoc.2... PMid:34869758 PMCid:PMC8639876.
 
32.
Zou X, Hall BJ, Xiong M, Wang C. Post-migration well-being of Sub-Saharan Africans in China: A nationwide cross-sectional survey. Qual Life Res. 2021;30(4):1025-35. https://doi.org/10.1007/s11136... PMid:33037533.
 
33.
Tanis M. The Oxford handbook of internet psychology. New York: Oxford University Press; 2007.
 
34.
Awang MM, Kutty FM, Ahmad AR. Perceived social support and well being: First-year student experience in university. Int Educ Stud. 2014;7(13):261-70. https://doi.org/10.5539/ies.v7....
 
35.
Toquero CMD. Will COVID-19 bring the armageddon? Expanding psychosocial support and environmental care: An autoethnographic research. Aquademia. 2020;4(2):ep20022. https://doi.org/10.29333/aquad....
 
36.
Fydrich T, Sommer G. Diagnostik sozialer Unterstützung [Diagnostics of social support]. Psychol Health Promot. 2003;79:104.
 
37.
Fydrich T, Geyer M, Hessel A, Sommer G, Brähler E. Fragebogen zur sozialen Unterstützung (F-SozU): Normierung an einer repräsentativen Stichprobe [Social support questionnaire (F-SozU): Standardization on a representative sample]. Diagnostica. 1999;45(4):212-6. https://doi.org/10.1026//0012-....
 
38.
Steese S, Dollete M, Phillips W, Hossfeld E, Matthews G, Taormina G. Understanding girls’ circle as an intervention on perceived social support, body image, self-efficacy, locus of control and self-esteem. J Psychol. 2004;90(2):204-15. PMid:16689441.
 
39.
Wang Z, Fu Y. Social support, social comparison, and career adaptability: A moderated mediation model. Soc Behav Pers. 2015;43(4):649-59. https://doi.org/10.2224/sbp.20....
 
40.
Curran PG. Methods for the detection of carelessly invalid responses in survey data. J Exp Soc Psychol. 2016;66:4-19. https://doi.org/10.1016/j.jesp....
 
41.
Group TW. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28(3):551-8. https://doi.org/10.1017/S00332... PMid:9626712.
 
42.
da Rocha NS, Power MJ, Bushnell DM, Fleck MP. The EUROHIS-QOL 8-item index: Comparative psychometric properties to its parent WHOQOL-BREF. Value Health. 2012;15(3):449-57. https://doi.org/10.1016/j.jval... PMid:22583455.
 
43.
Hays RD, DiMatteo MR. A short-form measure of loneliness. J Pers Assess. 1987;51(1):69-81. https://doi.org/10.1207/s15327... PMid:3572711.
 
44.
Trepte S, Dienlin T, Reinecke L. Influence of social support received in online and off-line contexts on satisfaction with social support and satisfaction with life: A longitudinal study. Media Psychol. 2015;18(1):74-105. https://doi.org/10.1080/152132....
 
45.
Kliem S, Mößle T, Rehbein F, Hellmann DF, Zenger M, Brähler E. A brief form of the perceived social support questionnaire (F-SozU) was developed, validated, and standardized. J Clin Epidemiol. 2015;68(5):551-62. https://doi.org/10.1016/j.jcli... PMid:25499982.
 
46.
Lin M, Hirschfeld G, Margraf J. Brief form of the perceived social support questionnaire (F-SozU K-6): Validation, norms, and cross-cultural measurement invariance in the USA, Germany, Russia, and China. Psychol Assess. 2019;31(5):609. https://doi.org/10.1037/pas000... PMid:30589275.
 
47.
Nick EA, Cole DA, Cho S-J, Smith DK, Carter TG, Zelkowitz R. The online social support scale: Measure development and validation. Psychol Assess. 2018;30(9):1127. https://doi.org/10.1037/pas000... PMid:29781664 PMCid:PMC6107390.
 
48.
Bender M, van Osch Y, Sleegers W, Ye M. Social support benefits psychological adjustment of international students: Evidence from a meta-analysis. J Cross Cult Psychol. 2019;50(7):827-47. https://doi.org/10.1177/002202....
 
49.
English AS, Zhang YB, Tong R. Social support and cultural distance: Sojourners’ experience in China. Int J Intercult Relat. 2021;80:349-58. https://doi.org/10.1016/j.ijin....
 
50.
Shu F, Ahmed SF, Pickett ML, Ayman R, McAbee ST. Social support perceptions, network characteristics, and international student adjustment. Int J Intercult Relat. 2020;74:136-48. https://doi.org/10.1016/j.ijin....
 
51.
Schmidt S, Mühlan H, Power M. The EUROHIS-QOL 8-item index: Psychometric results of a cross-cultural field study. Eur J Public Health. 2006;16(4):420-8. https://doi.org/10.1093/eurpub... PMid:16141303.
 
52.
Nagelkerke NJ. A note on a general definition of the coefficient of determination. Biometrika. 1991;78(3):691-2. https://doi.org/10.2307/233703....
 
53.
Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. New York, NY: Routledge; 2002. https://doi.org/10.4324/978020....
 
54.
Maldonado BMN, Collins J, Blundell HJ, Singh L. Engaging the vulnerable: A rapid review of public health communication aimed at migrants during the COVID-19 pandemic in Europe. J Migrat Health. 2020;1:100004. https://doi.org/10.1016/j.jmh.... PMid:33447830 PMCid:PMC7661962.
 
55.
Banati P, Jones N, Youssef S. Intersecting vulnerabilities: The impacts of COVID-19 on the psycho-emotional lives of young people in low-and middle-income countries. Eur J Dev Res. 2020;32(5):1613-38. https://doi.org/10.1057/s41287... PMid:33191985 PMCid:PMC7649704.
 
56.
Elmer T, Mepham K, Stadtfeld C. Students under lockdown: Comparisons of students’ social networks and mental health before and during the COVID-19 crisis in Switzerland. Plos One. 2020;15(7):e0236337. https://doi.org/10.1371/journa... PMid:32702065 PMCid:PMC7377438.
 
57.
Wathelet M, Duhem S, Vaiva G, et al. Factors associated with mental health disorders among university students in France confined during the COVID-19 pandemic. JAMA Netw Open. 2020;3(10):e2025591. https://doi.org/10.1001/jamane... PMid:33095252 PMCid:PMC7584927.
 
58.
Pai N, Vella S-L. COVID-19 and loneliness: A rapid systematic review. Aust N Z J Psychiatry. 2021;55(12):1144-56. https://doi.org/10.1177/000486... PMid:34256632.
 
59.
Leal Filho W, Wall T, Rayman-Bacchus L, et al. Impacts of COVID-19 and social isolation on academic staff and students at universities: A cross-sectional study. BMC Public Health. 2021;21(1):1-19. https://doi.org/10.1186/s12889... PMid:34167494 PMCid:PMC8223197.
 
60.
Swami V, Chamorro-Premuzic, T, Sinniah D, et al. General health mediates the relationship between loneliness, life satisfaction and depression. Soc Psychiatry Psychiatr Epidemiol. 2007;42(2):161-6. https://doi.org/10.1007/s00127... PMid:17180631.
 
61.
Utz S, Breuer J. The relationship between use of social network sites, online social support, and well-being: Results from a six-wave longitudinal study. J Media Psychol. 2017;29(3):115-25. https://doi.org/10.1027/1864-1... PMid:29147141 PMCid:PMC5683734.
 
62.
Merion I. Online social support: Just as valuable as off-line social support? 2017. Available at: https://scholarworks.calstate.... (Accessed 22 April 2022).
 
63.
Barreto M, Victor C, Hammond C, Eccles A, Richins MT, Qualter P. Loneliness around the world: Age, gender, and cultural differences in loneliness. Pers Individ Differ. 2021;169:110066. https://doi.org/10.1016/j.paid... PMid:33536694 PMCid:PMC7768187.
 
64.
Griffin J. The lonely society? London: Mental Health Foundation; 2010.
 
65.
Franklin A. A lonely society? Loneliness and liquid modernity in Australia. Aust J Soc Issues. 2012;47(1):11-28. https://doi.org/10.1002/j.1839....
 
66.
Lasgaard M, Friis K, Shevlin M. “Where are all the lonely people?” A population-based study of high-risk groups across the life span. Soc Psychiatry Psychiatry Epidemiol. 2016;51(10):1373-84. https://doi.org/10.1007/s00127... PMid:27571769.
 
67.
Cao W, Fang Z, Hou G, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934. https://doi.org/10.1016/j.psyc... PMid:32229390 PMCid:PMC7102633.
 
68.
Mucci F, Mucci N, Diolaiuti F. Lockdown and isolation: Psychological aspects of COVID-19 pandemic in the general population. Clin Neurospychiatry. 2020;17(2):63. https://doi.org/10.36131/CN202....
 
eISSN:2516-3507
Journals System - logo
Scroll to top