Assessment of the Psychological Stress Experienced by COVID Warriors during COVID-19 Pandemic in India

Shika Vardhan; Sudarshan Ramaswamy; Meera Dhuria; Rinku Sharma; Aman Pratap Singh; Smita Deshpande; Pradeep Kumar Kanaujiya; Alka Aggarwal; Sudhir Kumar Jain; Suneela Garg; Sujeet Kumar Singh

Shika Vardhan Joint Director, Centre for Environmental & Occupational Health, Climate Change & Health, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.
Sudarshan Ramaswamy WHO Consultant - Health Emergencies, NOA at NCDC, Delhi, India. / World Health Organization, WCO, Delhi, India.
Meera Dhuria Joint Director, Epidemiology Division, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.
Rinku Sharma Joint Director, Centre for Non-Communicable Diseases, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.
Aman Pratap Singh HOD Paediatrics Department, Bhagwan Mahavir Hospital, H-4/5, Pitampura, Delhi, India.
Smita Deshpande HOD Psychiatry Department, ABVIMS- Dr RML Hospital New Delhi, India.
Pradeep Kumar Kanaujiya HOD Psychiatry Department, ABVIMS- Dr RML Hospital New Delhi, India.
Alka Aggarwal Medical Superintendent, Bhagwan Mahavir Hospital, H-4/5, Pitampura, Delhi, India.
Sudhir Kumar Jain Additional Director & Head Epidemiology Division, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.
Suneela Garg Professor & Head, Community Medicine Department, Maulana Azad Medical College & Associated Hospitals New Delhi, India.
Sujeet Kumar Singh Director, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.

Keywords: Perceptive Stress Scale (PSS-10), Social stigma, Workload stress, PPEs, Mental health

Abstract

Introduction: In the fight against COVID-19, doctors, nurses, administrative staff, police personnel and other supporting staff have been in the frontline providing emergency services. While performing their duties, they are at risk of getting infections and transmitting them to their near and dear ones. This can lead to increased psychological stress levels among them. This study was conducted to assess the level of stress among health care workers and police personnel during the COVID-19 pandemic period in Delhi.

Methodology: This is a cross-sectional study among the COVID-19 warriors working in designated COVID-19 hospitals using Google forms. The relationship between various social, demographic, and administrative factors and the level of stress experienced by the study subjects was assessed using Perceptive Stress Scale (PSS-10).

Results: The results describe heightened severity of perception of stress among the study cohort. We found at least 10 risk factors that showed statistically significant association with increased TPSS in the studied cohort group.

Conclusion: There is an urgent need for screening, proper diagnosis, and management of psychiatric issues among FLCWs, and for expanding mental health services for reducing stress among the target population.

How to cite this article:
Vardhan S, Ramaswamy S, Dhuria M, Sharma R, Singh AP, Deshpande S, Kanaujiya PK, Aggarwal A, Jain SK, Garg S, Singh SK. Assessment of the Psychological Stress Experienced by COVID Warriors during COVID-19 Pandemic in India. J Commun Dis. 2021;53(4):6-14.

DOI: https://doi.org/10.24321/0019.5138.202168

Author Biographies

Shika Vardhan, Joint Director, Centre for Environmental & Occupational Health, Climate Change & Health, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.

Joint Director, Centre for Environmental & Occupational Health, Climate Change & Health

Sudarshan Ramaswamy, WHO Consultant - Health Emergencies, NOA at NCDC, Delhi, India. / World Health Organization, WCO, Delhi, India.

WHO Consultant (NOA) â€“ Health Emergencies,

at NCDC, Delhi

Meera Dhuria, Joint Director, Epidemiology Division, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.

Joint Director, Epidemiology Division

Aman Pratap Singh, HOD Paediatrics Department, Bhagwan Mahavir Hospital, H-4/5, Pitampura, Delhi, India.

HOD Paediatrics department

Smita Deshpande, HOD Psychiatry Department, ABVIMS- Dr RML Hospital New Delhi, India.

HOD Psychiatry department

Pradeep Kumar Kanaujiya, HOD Psychiatry Department, ABVIMS- Dr RML Hospital New Delhi, India.

Specialist - Pediatrics

Alka Aggarwal, Medical Superintendent, Bhagwan Mahavir Hospital, H-4/5, Pitampura, Delhi, India.

Medical Superintendent

Sudhir Kumar Jain, Additional Director & Head Epidemiology Division, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.

Additional Director & Head, Epidemiology Division

Suneela Garg, Professor & Head, Community Medicine Department, Maulana Azad Medical College & Associated Hospitals New Delhi, India.

Professor & Head, Community Medicine department

Sujeet Kumar Singh, Director, National Centre for Disease Control (NCDC), DGHS, MoHFW, Delhi, India.

Director

References

Pandey SK, Sharma V. Doctor, heal thyself: addressing the shorter life expectancy of doctors in India. Indian J Ophthalmol. 2019 Jul;67(7):1248-50. [PubMed] [Google Scholar]

Ramaswamy S, Joshi SM, Velankar DH, Gosavi JD. Assessment of risk scoring of non-communicable diseases among doctors in a medical college of Navi Mumbai: a cross sectional study. Int J Community Med Public Health. 2019;6:5283-9. [Google Scholar]

Lemaire JB, Wallace JE. Burnout among doctors. BMJ. 2017 Jul;358:j3360. [PubMed] [Google Scholar]

Li Z, Ge J, Yang M, Feng J, Qiao M, Jiang R, Bi J, Zhan G, Xu X, Wang L, Zhou Q, Zhou C, Pan Y, Liu S, Zhang H, Yang J, Zhu B, Hu Y, Hashimoto K, Jia Y, Wang H, Wang R, Liu C, Yang C. Vicarious traumatization in the general public, members, and non-members of medical teams aiding in COVID-19 control. Brain Behav Immune. 2020 Aug;88:916-9. [PubMed] [Google Scholar]

Liang Y, Chen M, Zheng X, Liu J. Screening for Chinese medical staff mental health by SDS and SAS during the outbreak of COVID-19. J Psychosome Res. 2020 Jun;133:110102. [PubMed] [Google Scholar]

Lu W, Wang H, Lin Y, Li L. Psychological status of medical workforce during the COVID-19 pandemic: A cross-sectional study. Psychiatry Res. 2020 Jun;288:112936. [PubMed] [Google Scholar]

Mo Y, Deng L, Zhang L, Lang Q, Liao C, Wang N, Qin M, Huang H. Work stress among Chinese nurses to support Wuhan for fighting against the COVID-19 epidemic. J Nurs Manag. 2020 Jul;28(5):1002-9. [PubMed] [Google Scholar]

Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, Wu J, Du H, Chen T, Li R, Tan H, Kang L, Yao L, Huang M, Wang H, Wang G, Liu Z, Hu S. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020 Mar;3(3):e203976. [PubMed] [Google Scholar]

Cabarkapa S, Nadjidai SE, Murgier J, Ng CH. The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: a rapid systematic review. Brain Behav Immun Health. 2020 Oct;8:100144. [PubMed] [Google Scholar]

Cohen S, Williamson G. Perceived stress in a probability sample of the United States In: Spacapam S, Oskamp S, editors. The Social Psychology of Health Newbury Park, CA: Sage; 1988. p. 31-67. [Google Scholar]

Chua SE, Cheung V, Cheung C, McAlonan GM, Wong JW, Cheung EP, Chan MT, Wong MM, Tang SW, Choy KM, Wong MK, Chu CM, Tsang KW. Psychological effects of the SARS outbreak in Hong Kong on high-risk health care workers. Can J Psychiatry. 2004 Jun;49(6):391-3. [PubMed] [Google Scholar]

Limcaoco RS, Mateos EM, Fernandez JM, Roncero C. Anxiety, worry and perceived stress in the world due to the COVID-19 pandemic, March 2020. Preliminary results. MedRxiv. 2020 Jan 1.[Google Scholar]

Nair A, Menon J, Rammohan A, Hakeem AR, Cherukuri SD, Shanmugam N, Rajakumar A, Reddy MS, Kaliamoorthy I, Rela M. Are our COVID warriors cared-for enough? A nationwide survey on stress among doctors during the COVID-19 Pandemic. MedRxiv. 2020 Jan 1. [Google Scholar]

Grover S, Sahoo S, Dua D, Mehra A, Nehra R. Psychological impact of COVID-19 duties during lockdown on police personnel and their perception about the behavior of the people: an exploratory study from India. Int J Ment Health Addict. 2020 Nov 5;1-12. [PubMed] [Google Scholar]

Halder A, Ghosh A, Mondal N, Desai B, Das P, Maity S. Calling out the COVID blues-how much of a psychological impact does the COVID-19 pandemic have on health care professionals in India. Asian J Med Sci. 2021 May;12(5):7-14. [Google Scholar]

Hackett RA, Steptoe A. Type 2 diabetes mellitus and psychological stress - a modifiable risk factor. Nat Rev Endocrinol. 2017 Sep;13(9):547. [PubMed] [Google Scholar]

Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol. 2008 Apr;51(13):1237-46. [PubMed] [Google Scholar]

Kalache A, Kickbusch I. A global strategy for healthy ageing. World Health. 1997;50(4):4-5. [Google Scholar]

WHO [Internet]. COVID-19 Course Series. Real-time training for the coronavirus disease outbreak. [cited 2021 Mar 25] Available from: https://openwho.org/channels/covid-19

Lucchini A, Giani M, Elli S, Villa S, Rona R, Foti G. Nursing Activities Score is increased in COVID-19 patients. Intensive Crit Care Nurs. 2020 Aug;59:102876. [PubMed] [Google Scholar]

Wu AW, Connors C, Everly Jr GS. COVID-19: peer support and crisis communication strategies to promote institutional resilience. Ann Intern Med. 2020 Jun;172(12):822-3. [PubMed] [Google Scholar]

LatestLaws.com [Internet]. COVID-19: Delhi Government orders penal action against landlords harassing health workers to vacate homes; [cited2020 Mar 25]. Available from: https://www.latestlaws.com/latest-news/covid-19-delhi-govt-orders-penal-action-against-landlords-harassing-health-workers-to-vacate-homes/

Ramaci T, Barattucci M, Ledda C, Rapisarda V. Social stigma during COVID-19 and its impact on HCWs outcomes. Sustainability. 2020 Jan;12(9):3834. [Google Scholar]