Background COVID-19 has inundated the entire world disrupting the lives of millions of people. The pandemic has stressed the healthcare system of India impacting the psychological status and functioning of health care workers. The aim of this study is to determine the burnout levels and factors associated with the risk of psychological distress among healthcare workers (HCW) engaged in the management of COVID 19 in India. Methods A cross-sectional study was conducted from 1 September 2020 to 30 November 2020 by telephonic interviews using a web-based Google form. Health facilities and community centres from 12 cities located in 10 states were selected for data collection. Data on socio-demographic and occupation-related variables like age, sex, type of family, income, type of occupation, hours of work and income were obtained was obtained from 967 participants, including doctors, nurses, ambulance drivers, emergency response teams, lab personnel, and others directly involved in COVID 19 patient care. Levels of psychological distress was assessed by the General health Questionnaire -GHQ-5 and levels of burnout was assessed using the ICMR-NIOH Burnout questionnaire. Multivariable logistic regression analysis was performed to identify factors associated with the risk of psychological distress. The third quartile values of the three subscales of burnout viz EE, DP and PA were used to identify burnout profiles of the healthcare workers. Results Overall, 52.9% of the participants had the risk of psychological distress that needed further evaluation. Risk of psychological distress was significantly associated with longer hours of work (≥ 8 hours a day) (AOR = 2.38, 95% CI(1.66–3.41), income≥20000(AOR = 1.74, 95% CI, (1.16–2.6); screening of COVID-19 patients (AOR = 1.63 95% CI (1.09–2.46), contact tracing (AOR = 2.05, 95% CI (1.1–3.81), High Emotional exhaustion score (EE ≥16) (AOR = 4.41 95% CI (3.14–6.28) and High Depersonalisation score (DP≥7) (AOR = 1.79, 95% CI (1.28–2.51)). About 4.7% of the HCWs were overextended (EE>18); 6.5% were disengaged (DP>8) and 9.7% HCWs were showing signs of burnout (high on all three dimensions). Conclusion The study has identified key factors that could have been likely triggers for psychological distress among healthcare workers who were engaged in management of COVID cases in India. The study also demonstrates the use of GHQ-5 and ICMR-NIOH Burnout questionnaire as important tools to identify persons at risk of psychological distress and occurrence of burnout symptoms respectively. The findings provide useful guide to planning interventions to mitigate mental health problems among HCW in future epidemic/pandemic scenarios in the country.

Background and Objective:Postnatal depression, with an estimated prevalence of 13-19%, causes significant impairment of mental health among women worldwide and has long term consequences. However, more than half of all cases are not detected by healthcare providers. Screening for postnatal depression has not been given importance in maternal health programs in India. Our objective was to screen for postnatal depression among women attending a rural hospital in India, immediately postpartum and at 6-8 weeks post-delivery, and to study associated factors.Methods:A cross sectional study was done on 123 postnatal women attending a rural maternity hospital in Karnataka, South India, of whom 74 women were interviewed within one week of childbirth, and 49 women at 6-8 weeks post-delivery. The Edinburgh Postnatal Depression Scale was used to screen for postnatal depression.Results:About 45.5% of the women screened positive for postnatal depression (44.6% of all subjects within one week of delivery and 46.9% at 6-8 weeks after delivery). Postnatal depression was significantly associated with mood swings during antenatal period, staying with the family of birth during pregnancy and away from their husbands, and was significantly higher among women who perceived their life as stressful and having a low self-esteem (P<0.05)Conclusions:This study found a high prevalence of postnatal depression in women in rural Karnataka. This underlines the need for incorporating screening for postnatal depression in the routine care of women during pregnancy and delivery.

Background & objectives : The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored. Methods : A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India. Results : HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic. Interpretation & conclusions : The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families.

Background: Under detection of dementia is a major challenge in low and middle income countries with 90% of dementia cases remaining unidentified in India. The objective of the study was to assess the prevalence and risk factors of dementia among older adults living in an urban underprivileged area of Bangalore city, India using the picture memory impairment screen (PMIS).Methods: This community based cross sectional study was conducted between September and November 2013 among 202 elderly people in an underprivileged area of Bangalore city. Dementia was defined using a validated cut-off score on the PMIS.Results: The mean age of the participants was 68 years and 65% were illiterate. The overall prevalence of dementia using the screen among elderly people was 15.3%. Age specific prevalence rates were 7.8% (60 to 70), 30.6% (71 to 80) and 61.5% (>80 years) respectively. Increasing age, family history, lower educational and functional status were significantly associated (p<0.05) with dementia.Conclusions: High prevalence of dementia was identified among an urban underprivileged elderly population. The PMIS can be used to triage older adults for further evaluation and management.

Introduction:The construction industry, which mainly consists of migrant labouers is one of the largest employers in the unorganized sector in India. These workers work in poor conditions and are often vulnerable to exploitation. These workers also do not have health care benefits and often these factors lead to poor quality of life (QOL) and psychological distress.Objectives:To assess the QOL, probable psychological distress and associated factors among male construction workers.Materials and Methods:A cross-sectional study was conducted between September 2013 and November 2013 among 404 male workers. These construction workers were enrolled by consecutive sampling at a construction area in Kolar district, Kaarnataka, India. The study tools used were World Health Organization (WHO) QOL-BREF and 12-Item General Health Questionnaire (GHQ-12) to assess QOL and probable psychological distress, respectively. The transformed scores in WHO QOL-BREF in all four domains ranged 0–100. The four domain scores are scaled in a positive direction with higher scores indicating a higher QOL. Associations were done using statistical tests such as Chi-square, correlation, regression, independent samples t-test, and analysis of variance (ANOVA).Results:A total of 404 male workers with a mean age of 25.6 ± 7.3 years were studied. Mean scores of various domains of QOL were 68.5 ± 13.7 (physical), 59.9 ± 13.5 (psychological), 64.3 ± 16.4 (social), and 44.1 ± 12.8 (environmental). On the self- rating scale, 59 (14.6%) workers were rated as having poor QOL. The prevalence of probable psychological distress was 27.5%. Factors such as increasing age, being currently married, and low educational status were found to be significantly associated (P < 0.05) with poor QOL and psychological distress. There was a significant negative correlation (P < 0.05) between QOL and psychological distress and a positive correlation between income and QOL.Conclusion:The QOL in the environmental domain, which mainly deals with living conditions, health, and recreational facilities was found to be poor and there was a high prevalence of probable psychological distress among workers. This indicates a need for improving workplace amenities, and access to health and recreational facilities.