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. 2020 Nov;10(11):e01837.
doi: 10.1002/brb3.1837. Epub 2020 Sep 11.

Mental health and quality of life among healthcare professionals during the COVID-19 pandemic in India

Nishi Suryavanshi  1   2 , Abhay Kadam  1   2 , Gauri Dhumal  1   2 , Smita Nimkar  1   2 , Vidya Mave  3 , Amita Gupta  3 , Samyra R Cox  3 , Nikhil Gupte  1   3
Affiliations

Mental health and quality of life among healthcare professionals during the COVID-19 pandemic in India

Nishi Suryavanshi et al. Brain Behav. 2020 Nov.

Abstract

Background: The COVID-19 pandemic has placed healthcare professionals (HCP) in stressful circumstances with increased patient loads and a high risk of exposure. We sought to assess the mental health and quality of life (QoL) of Indian HCPs, the fourth highest-burden country for COVID-19.

Method: Using snowball sampling, we conducted an online survey in May 2020 among HCPs. Data were collected on demographics, depression, and anxiety using validated tools, quality of life, and perceived stressors. Multivariable logistic regression and principal component analysis were performed to assess risk factors associated with mental health symptoms.

Findings: Of 197 HCPs assessed, 157 (80%) were from Maharashtra, 130 (66%) from public hospitals, 47 (24%) nurses, 66 (34%) physicians, 101 (52%) females, and 81 (41%) ≤30 years. Eighty-seven percent provided direct COVID-19 care with 43% caring for >10 patients/day. A large proportion reported symptoms of depression (92, 47%), anxiety (98, 50%), and low QoL (89, 45%). Odds of combined depression and anxiety were 2.37 times higher among single HCPs compared to married (95% CI: 1.03-4.96). Work environment stressors were associated with 46% increased risk of combined depression and anxiety (95% CI: 1.15-1.85). Moderate to severe depression and anxiety were independently associated with increased risk of low QoL [OR: 3.19 (95% CI: 1.30-7.84), OR: 2.84 (95% CI: 1.29-6.29)].

Conclusion: Our study demonstrated a high prevalence of symptoms of depression and anxiety and low QoL among Indian HCPs during the COVID-19 pandemic. There is an urgent need to prevent and treat mental health symptoms among frontline HCPs.

Keywords: COVID-19; India; healthcare professionals; mental health; quality of life; stressors.

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Conflict of interest statement

None.

Figures

FIGURE 1
FIGURE 1
Map of India and Maharashtra showing geographical distribution of HCPs. Almost 80% of HCPs were from Maharashtra, epicenter of COVID‐19 epidemic in India
FIGURE 2
FIGURE 2
Association of moderate to severe depression and anxiety by quality of life. Quality of life (QoL) was measured on Likert scale ranging from 1 to 7; score >4 was considered as high QoL; score of 4 is average QoL; and score below 4 is low QoL. Effect of moderate to severe depression and anxiety on QoL using Fisher's exact test shows significant association. Moderate to severe depression is defined as depression score ≥10 on Patient health Questionnaire (PHQ‐9), and presence of moderate to severe anxiety is defined as score ≥8 on General Anxiety Disorder (GAD‐7) scale; presence of moderate to severe depression and anxiety combined included those HCPs who reported both moderate to severe depression and anxiety
FIGURE 3
FIGURE 3
Distribution of stressors by mental health symptoms. There are 12 major stressors contributing to moderate to severe depression and anxiety. Moderate to severe depression is defined as depression score ≥10 on Patient health Questionnaire (PHQ‐9), and presence of moderate to severe anxiety is defined as score ≥8 on General Anxiety Disorder (GAD‐7) scale; presence of moderate to severe depression and anxiety combined included those HCPs who reported both moderate to severe depression and anxiety
FIGURE 4
FIGURE 4
(a) Effect of perceived stressors on moderate to severe depression using principal components multivariable analysis. (b) Effect of moderate to severe anxiety using principal components multivariable analysis. (c) Effect of moderate to severe depression and anxiety combined using principal components multivariable analysis. Factor loading most represented in component 1 (Work Environment) are as follows: lack of knowledge and equipment, lack of manpower, fear of infection. Factor loading most represented in component 2 (Work Pressure) are as follows: pressure due to increase in patient load, pressure from seniors, discrimination from co‐workers/family, worry about death rate among patients. Factor loading most represented in component 3 (Epidemic) are as follows: isolation and physical distancing, uncertainty of epidemic control, and factor loading most represented in component 4 (Family‐related) are as follows: fear of transmission of infection to family, loss of family members/friends/relatives
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