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. 2025 Aug 9;5(1):119.
doi: 10.1007/s44192-025-00241-2.

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

Jerry Paul K Ninnoni  1 , Isaac Tetteh Commey  2 , Emmanuel Budu Harmah  3 , Mustapha Amoadu  4
Affiliations

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

Jerry Paul K Ninnoni et al. Discov Ment Health. .

Abstract

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.

Keywords: Chronic conditions; Coping; Ghana; Mental health; Vaccine acceptancy.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study received ethical clearance from the Institutional Review Board of the University of Cape Coast, Ghana, with approval number (ID: UCCIRB/CES/2022/82). All procedures involving human participants were conducted in accordance with the ethical standards of the University of Cape Coast and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from all participants prior to their inclusion in the study. Participants were informed about the study’s purpose, their right to withdraw at any time without consequence, and the confidentiality of their responses. Consent for publish: Participants consented to the use of anonymized data for academic publication. No identifying information is included in the manuscript. Authors’ consent to publish: All authors have read and approved the final manuscript and consent to its submission and potential publication. They affirm that the work is original and has not been published elsewhere in whole or in part. Competing interest: Authors declare no conflict of interest.

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