Abstract
The situation after the COVID-19 outbreak has affected all aspects of the world, causing
people in all sectors to be concerned about their well-being and economy. They also have to
take care of themselves by quarantining at home when they are exposed to or at risk of being
re-infected with COVID. As a result, many people have become stressed and have mental health
problems. It was found that the online mental health assessment data from the Department of
Mental Health revealed that the mental health of Thais after the COVID-19 outbreak during May-November 2023, the group under 20 years old is at high risk of depression as high as 34.1%,
returning to the same level as during the COVID-19 outbreak. Therefore, this research focuses on
public participation to study the mental health and stress management of Thai people after the
COVID-19 outbreak. It aims to promote mental health in a new normal way of life in the target
group with mild to moderate stress problems. To access the real problems of Thai people by
using Biofeedback in the evaluation results This study is a participatory action research to study
the mental health and stress management of Thai people in the post-COVID-19 era to support
the new normal way of life. There were 3 stages of the study. The urban communities studied
were selected by purposive sampling. The sample group consisted of 175 urban residents in all
3 stages, selected by multi-stage sampling. The sample group had to reside in the urban
communities and have a fair understanding of the context of the urban communities in which
they lived.
The data analysis process is divided into 3 stages. Stage 1 is a mixed methods research,
so we chose to use quantitative data analysis. Descriptive statistics (frequency, percentage,
mean, standard deviation (SD) and range are used to describe the characteristics of the
population, the characteristics of the variables used in the study, and the stress level scores.
Factors related to stress and mental health are analyzed by comparing the mean values,
classified by general data factors, divided into 2 groups using the Independent t-test and divided
into more than 2 groups using the One-way ANOVA statistics. Factors influencing stress and
mental health are analyzed using the Multiple Linear Regression analysis. Qualitative data
analysis is categorized using the Thematic analysis method. Stage 2 is a Participatory Action
Research (PAR) by interviewing along the lines of focus group discussion. Then, qualitative data
will be analyzed by categorizing the data using thematic analysis method as well. Phase 3 is
quantitative research. Quasi-Experimental research design will be used to analyze data using
descriptive statistics (frequency, percentage, mean, standard deviation (SD) and range) to
describe demographic data, characteristics and variables used in the study, including stress and
mental well-being. And using two-way repeated measure ANOVA (one within-one between) using
the difference in mean scores for stress and mental well-being to compare between the
experimental and control groups with 2 measurement periods: before the experiment (preintervention) (Week 0) and after the experiment (post-intervention) (Week 2).
The research findings revealed that the majority of participants (87.8%) continued to
experience moderate to high levels of stress even after the pandemic period had passed.
Factors that were statistically significantly associated with stress included income adequacy,
presence of chronic diseases, gender, educational level, and occupation. Specifically, females
experienced significantly higher stress levels than males (p<0.05). Individuals with chronic
diseases had significantly higher stress levels than those without chronic diseases (p<0.01).
Those with higher educational levels experienced significantly more stress than those with
lower educational levels (p<0.05). The unemployed/housewife group had significantly
higher stress levels than other occupational groups (p<0.01), and individuals with
inadequate income experienced significantly more stress than those with adequate
income (p<0.001).
The context of stress shifted from fear of infection during the pandemic outbreak to
economic concerns and income recovery in the post-pandemic period. Participants managed
stress through physical health care, cognitive reframing, information seeking, and relying on social
support.
The results of the participatory stress management program intervention, developed
based on the Health Literacy framework, demonstrated statistically significant effectiveness
in reducing stress (p<0.001) when comparing the experimental group with the control group, and
significantly improved mental well-being (p<0.01), particularly in the dimensions of personal
growth, positive relationships with others, and purpose in life, which showed significantly greater
score improvements compared to the control group (p<0.05).
This research recommends that relevant agencies develop community-level mental
health promotion policies, integrate mental health services into primary healthcare systems,
establish mental health learning centers, and support economic strengthening at household and
community levels to effectively accommodate the new normal lifestyle.
