The COVID-19 Pandemic and Its Effect on the Mental Health of Doctors in India

Main Article Content

Amritha Nair
Jagadeesh Menon
Ashwin Rammohan
Abdul R. Hakeem
Sathya D. Cherukuri
Mettu S. Reddy
Mohamed Rela

Abstract

Background and Objectives: For doctors at the forefront of the COVID-19 pandemic, failure to acknowledge and act on the warning signs of stress can adversely affect their professional, social and personal life. We conducted a nationwide survey of a large sample of Indian doctors to measure levels of perceived stress, identify risk factors for severe stress and assess their response to current issues related to the safety and well-being of the community.

Methods: An online survey using Google forms was conducted between 1st May 2020 and 15th May 2020. The core component of the survey was the standardized Perceived Stress Scale answered on a Likert scale.

Results: Out of 520 responders, 394 (76%) were under 45 years of age 101 (19%) were between 18-30 years and 37 (7%) were above 60 years. 312(60%) were male doctors and 203 (40%) were female doctors. 90% of respondents had a post-graduate degree, 48(9%) had undergraduate degree and 168(32%) had super specialty degree. 313 (60.2%) of the respondents were practising in the private sector, 169 (33%) worked in public sector hospitals and 32(7%) in charitable hospitals. 109 (21%) had low stress, while 371 (71%) and 40 (8%) reported moderate and severe stress respectively. Multivariate analysis revealed the female gender, being financially insecure and ICU a place of work as independent risk factors for severe stress.

Conclusion: This is the first such survey done in the context of the COVID-19 pandemic from the Indian sub-continent and has identified factors that have the potential to adversely impact the mental health of doctors. These findings are applicable to many countries in Asia and Africa with similar healthcare systems and can act as a valuable guide for authorities to establish support systems at multiple levels for these “COVID Warriors”.

Keywords:
COVID-19, doctors, mental health, stress, risk factor.

Article Details

How to Cite
Nair, A., Menon, J., Rammohan, A., Hakeem, A. R., Cherukuri, S. D., Reddy, M. S., & Rela, M. (2020). The COVID-19 Pandemic and Its Effect on the Mental Health of Doctors in India. Asian Journal of Medicine and Health, 18(11), 55-70. https://doi.org/10.9734/ajmah/2020/v18i1130269
Section
Original Research Article

References

Kumar SU, Kumar DT, Christopher BP, Doss CGP. The Rise and Impact of COVID-19 in India. Front Med (Lausanne). 2020;7:250.

Kasthuri A. Challenges to healthcare in India - The Five A’s. Indian J Community Med. 2018;43:141–3.

Agarwal SK. Healthcare in India and violence against doctors: The missing links. Indian J Nephrol. 2019;29:221–31.

Bi Q, Wu Y, Mei S, Ye C, Zou X, Zhang Z et al. Epidemiology and transmission of COVID-19 in 391 cases and 1286 of their close contacts in Shenzhen, China: A retrospective cohort study. Lancet Infect Dis. 2020;20:911–9.

Koh D. Occupational risks for COVID-19 infection. Occup Med (Lond). 2020;70:3–5.

Shaukat N, Ali DM, Razzak J. Physical and mental health impacts of COVID-19 on healthcare workers: A scoping review. Int J Emerg Med. 2020;13:40 .

Iyengar KP, Jain VK, Vaishya R.Current situation with doctors and healthcare workers during COVID-19 pandemic in India. Postgrad Med J Published Online First: 19 August 2020. DOI: 10.1136/postgradmedj-2020-138496

Balasubramanian A, Paleri V, Bennett R, Paleri V. Impact of COVID-19 on the mental health of surgeons and coping strategies. Head Neck. 2020;42:1638-1644.

Pragati H, Angel S, Vivek D, Lathadevi C, Adhip A. Healthcare delivery in India amid the Covid-19 pandemic: Challenges and opportunities. Indian J Med Ethics. 2020;3:215-218.

Krystal JH, Mc Neil RLJ. Responding to the hidden pandemic for healthcare workers: Stress. Nat Med. 2020;26:639.

Khalid I, Khalid TJ, Qabajah MR, Barnard AG, Qushmaq IA. Healthcare workers emotions, perceived stressors and coping strategies during a MERS-CoV Outbreak. Clin Med Res. 2016;14:7–14.

Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception and altruistic acceptance of risk. Can J Psychiatry. 2009;54:302–11.

Stanetic KD, Savic SM, Racic M. The prevalence of stress and burnout syndrome in hospital doctors and family physicians. Med Pregl. 2016;69:356–65.

Alosaimi FD, Alawad HS, Alamri AK, Saeed AI, Aljuaydi KA, Alotaibi AS et al. Patterns and determinants of stress among consultant physicians working in Saudi Arabia. Adv Med Educ Pract. 2018;9:165–74.

Grover S, Sahoo S, Bhalla A, Avasthi A. Psychological problems and burnout among medical professionals of a tertiary care hospital of North India: A cross-sectional study. Indian J Psychiatry. 2018;60:175–88.

Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw open. 2020;3:e203976.

Cai H, Tu B, Ma J, Chen L, Fu L, Jiang Y et al. Psychological impact and coping strategies of frontline medical staff in hunan between january and march 2020 during the outbreak of coronavirus disease 2019 (COVID 19) in Hubei, China. Med Sci Monit Int Med J Exp Clin Res. 2020;26:e924171.

Mohindra RRR, Suri V, Bhalla A, Singh SM. Issues relevant to mental health promotion in frontline health care providers managing quarantined/isolated COVID19 patients. Asian J Psychiatr. 2020;51: 102084.

Berlanda S, Pedrazza M, Fraizzoli M, de Cordova F. Addressing risks of violence against healthcare staff in emergency departments: The effects of job satisfaction and attachment style. Biomed Res Int. 2019;5430870.

Ambesh P. Violence against doctors in the Indian subcontinent: A rising bane. Indian heart J. 2016;68:749–50.

Tan BYQ, Chew NWS, Lee GKH, Jing M, Goh Y, Yeo LLL et al. Psychological impact of the COVID-19 pandemic on health care workers in singapore. Ann Intern Med. 2020;173:317-320.

Salman M, Raza MH, Mustafa ZU, Khan TM, Asif N, Tahir H et al. The psychological effects of COVID-19 on frontline healthcare workers and how they are coping: A web-based, cross-sectional study from Pakistan. medRxiv [Internet]. 2020;2020.06.03.20119867. Available:http://medrxiv.org/content/early/2020/06/05/2020.06.03.20119867.abstract

Childs E, de Wit H. Regular exercise is associated with emotional resilience to acute stress in healthy adults. Front Physiol. 2014;5:161.

Tripathi MN, Kumari S, Ganpat TS. Psychophysiological effects of yoga on stress in college students. J Educ Health Promot. 2018;7:43.

González K, Fuentes J, Márquez JL. Physical inactivity, sedentary behavior and chronic diseases. Korean J Fam Med. 2017;38:111–5.