Mental health issues, coping mechanisms, and COVID-19 vaccine acceptance among chronically ill patients in tertiary health facilities in Central Region, Ghana.

Background: The COVID-19 pandemic has emphasised the importance of vaccination, particularly for individuals with chronic conditions. However, vaccine acceptancy is influenced by psychological distress and coping mechanisms. This study aimed to examine the influence of mental health issues (anxiety, depression, and stress) and coping strategies on vaccine acceptancy.

Method: A cross-sectional survey was conducted among 457 individuals with diabetes and hypertension attending two healthcare facilities in Ghana. Participants completed validated measures, including the Depression Anxiety Stress Scale (DASS-21), the Africultural Coping System Inventory (ACSI), and the COVID-19 Vaccine Acceptance Scale. Descriptive statistics, correlational analysis and hierarchical regression analysis were used to assess predictors of vaccine acceptancy using Jamovi statistical software version 2.6.63.

Results: The study found that stress, anxiety, and depression were strongly correlated, with higher levels of psychological distress linked to lower COVID-19 vaccine acceptancy. The multivariate results after adjusting for socio-demographic factors, anxiety (β = - 0.439, p <.001) and depression (β = - 0.455, p <.001) were strong negative predictors of vaccine acceptancy. Cognitive-emotional debriefing (β = 0.129, p =.012) was the only coping strategy significantly associated with higher vaccine acceptancy, while spiritual, collective, and ritual coping strategies had no significant impact after controlling for confounders. Education level (β = - 0.136, p <.001) remained significant predictors indicating that highly educated individuals showed lower vaccine acceptance.

Conclusion: The study suggests that mental health issues significantly influence vaccine acceptance, with cognitive-emotional debriefing playing a crucial role in moderating hesitancy. These findings highlight the need for integrating mental health support into vaccination strategies to enhance vaccine confidence among individuals with chronic conditions.