Effects of Tele-Counseling on Reducing Anxiety Levels of COVID-19 Patients in Isolation Wards: An Observational Study

Abstract

Background: COVID-19 causes psychological distress and anxiety due to fear of infection and the possibility of worsening symptoms leading to mortality. Public health measures like contact tracing and lockdowns further increase the panic among infected patients and the public. We intended to assess the effect of telecounseling in reducing anxiety in patients admitted to isolation wards. Methods: In this multi-center observational study, we administered a Generalized Anxiety Disorder-7 (GAD-7) scale before and after telecounseling. The study group consisted of participants who gave consent for telecounseling, and those who did not give consent constituted the control group. The telecounseling was based on the Psychological First Aid model, due to its simplicity. Results: There was a statistically significant decrease in anxiety after telecounseling in the study group (P value ≤ 0.001, effect size = 0.484). There was a statistically significant decrease in anxiety in the study group compared to the control group (P value ≤ 0.001). Conclusion: Telecounseling contributed to the reduction in anxiety in COVID-19 patients in isolation wards. Several other factors like severity of the infection, comorbid medical illness, pre-existing mental health issues, individual’s level of coping with stress, and duration and place of admission may have affected the anxiety levels in the patients.

Tele‐mental health during the COVID‐19 pandemic: A systematic review of the literature focused on technical aspects and challenges

“…[14][15][16] Most articles focused on the high-income countries of the World Bank (7, 53.8%) [10][11][12][17][18][19] and high-middle income (2, 15.3%). 20,21 Four articles focused on low-middle-income countries [14][15][16]22 and one article focused on low-income countries. 23 Four groups of participants involved in the use of tele-mental health were identified in the articles, the most common participants being patients and caregivers (11, 84.6%).…”

“…According to the results in Table 2, except for four articles, the rest of the articles addressed the challenges of using tele‐mental health. These challenges primarily included technological barriers and technical issues, which were stated in six articles 12,15–18,23 . These barriers included access to electronic and communication devices, the Internet and/or network connection problems, audio and video problems, and lack of access to mobile phones and local infrastructure.…”

“…The articles identified in our review were written with the purpose of using tele‐mental health. According to the tree diagram in Figure 2, there were seven specific purposes among the articles, the most of which was the use of tele‐mental health in the field of psychological support and counseling (11, 84.6%) 10–12,14–17,20–23 . In addition to psychological support and counseling, two articles described the field of educational counseling/cognitive behavior therapy 14,23 .…”

“…The articles addressed a variety of issues in tele‐mental health, which are listed in Table 2. Among these issues, stress, anxiety, and depression were the most considered (10, 76.9%) 10–16,19–22 . One article reviewed remote mental health for patients with dementia disease 17 .…”

“…The identified articles were implemented in eight countries. Among the articles that have identified a country, most of the articles are related to Italy (4, 30.7%), 10–13 followed by India, 14,15 with three articles 14–16 . Most articles focused on the high‐income countries of the World Bank (7, 53.8%) 10–12,17–19 and high‐middle income (2, 15.3%) 20,21 .…”