Loneliness and trust issues reshape mental stress of expatriates during early COVID-19: a structural equation modelling approach.

Objectives: To explore relationship among perceived stress regarding loneliness, interpersonal trust and institutional trust of expatriates during the early COVID-19 period (from 30^th March to 30^th May 2020). Methods: Data from 21,439 expatriates were extracted from COVIDiSTRESS global survey. The outcome variable was perceived stress. The explanatory variables were age, perceived loneliness, trust (interpersonal and institutional). Pairwise correlation, and structural equation modelling were used to determine relationship among outcome and explanatory variables. Results: The majority of the expatriates were female (73.85%), married (60.20%), had college degree (47.76%), and employed (48.72%). Over 63% of the total expatriates reported that the COVID-19 pandemic changed their lives. The average age of the respondents was 40.4 years (± 13.7), and the average score of perceived stress, loneliness, interpersonal and institutional trust were 25.5, 7.4, 14.2 and 40.4, respectively. We found a moderate correlation of perceived stress with age, perceived loneliness, interpersonal trust and institutional trust (p < 0.001). They were also found moderately related to each other. Structural equation modelling evaluated that a lack of trust can cause loneliness among expatriates, which later lead to perceived stress. Interpersonal trust was more likely to be associated with stress than institutional trust, whereas perceived loneliness mediated between both trusts and perceived stress. Conclusion: Perceived stress can be reduced through trusting others and alleviating the loneliness. Making strong linkage among migrants as well as between migrants and local community is important to ensure proper mental wellbeing of expatriates. [ABSTRACT FROM AUTHOR]