Do Low Self-Esteem and High Stress Lead to Burnout Among Health-Care Workers? Evidence From a Tertiary Hospital in Bangalore, India

Background@#Low self-esteem can be an issue among health-care workers due to the hierarchical medical system. Health-care workers are also in a high pressure environment that can lead to stress and burnout. This study was conducted to estimate the proportion of health-care workers with low self-esteem, high stress, and burnout and the factors associated with these in a private hospital in Bangalore city. @*Methods@#This cross-sectional study included a random sample of health-care workers of various cadres – doctors, nurses, nursing aides, technicians, and workers in ancillary departments such as laundry, dietary, central sterile supply department, and pharmacy, with probability proportional to size. Rosenberg Scale for Self-esteem, Cohen's Perceived Stress Scale, and Shirom–Melamed Burnout Measure were used as study tools. @*Results@#Among the 306 health-care workers, there were high levels of low self-esteem (48.4%), stress (38.6%), and burnout (48.7%), with the lowest levels being among doctors. Those aged younger than 30 years had significantly lower self-esteem and greater stress. @*Conclusions@#Health-care workers with low self-esteem were nearly thrice more likely to suffer high stress, Odds Ratio (OR) = 2.84 (1.36–5.92), and those who were stressed had more than three times higher chance of experiencing burnout, OR = 3.6 (2.02–6.55). Path analysis showed that low self-esteem among health-care workers had a direct effect on burnout, as well as an indirect effect through stress (mediator variable). This study indicates the need for screening and counseling for low self-esteem, stress, and burnout as part of a periodic medical examination of all cadres of health workers.

Shift work disorder and its related factors among health-care workers in a Tertiary Care Hospital in Bangalore, India

Background and Objective: Shift work disorder is the presence of excessive day time sleepiness and insomnia affecting people whose work hours overlap with the typical sleep period. Shift work has pronounced effect on physical and mental health of an individual. Our objective was to estimate the prevalence of symptoms of shift work disorder and the factors associated with it among hospital staff in a tertiary care hospital in Bangalore, India

Methods: This cross-sectional study was conducted at a private teaching tertiary hospital among 318 hospital workers in Bangalore during September to December 2015. Stratified random sampling method was used and the study population was divided into five strata based upon their parent department. Socioeconomic details, work profile and standard tools– Insomnia severity index, The Epworth sleepiness scale and the FACIT fatigue scale were used

Results: Of the 318 workers, 290 [91.2 percent] were females, between 21-25 years of age. Most had work experience of

Conclusion: Periodic screening during annual medical check-ups and health education on practicing good sleep hygiene will help address this important issue of shift work disorders among workers

Postnatal depression among women availing maternal health services in a rural hospital in south India

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. 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. 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] 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

case of pigmented fungiform papillae of the tongue in a Middle Eastern woman

To report a case of pigmented fungiform papillae on the tongue. Clinical Presentation and Intervention: A 29-year-old female presented with patchy pigmented areas on her tongue of 2 years' duration. Examination of the tongue showed pigmentation confined to the fungiform papillae on the dorsum of the tongue. She was healthy and was not taking any medications and hence a diagnosis of pigmented fungiform papillae was considered. The patient was reassured of the benign nature of this condition and no treatment was given. However, a 6-month follow-up was suggested. Clinicians should be aware of this benign variant of lingual pigmentation to avoid confusion with pathological conditions and also to avoid unnecessary investigative procedures

Prevalence of oral mucosal lesions in patients of the Kuwait University Dental Center

The purpose of this study was to determine the number, types, and locations of oral mucosal lesions in patients who attended the Admission Clinic at the Kuwait University Dental Center to determine prevalence and risk factors for oral lesions. Intraoral soft tissue examination was performed on new patients seen between January 2009 and February 2011. The lesions were divided into six major groups: white, red, pigmented, ulcerative, exophytic, and miscellaneous. Five hundred thirty patients were screened, out of which 308 [58.1%] had one or more lesions. A total of 570 oral lesions and conditions were identified in this study, of which 272 [47.7%] were white, 25 [4.4%] were red, 114 [20.0%] were pigmented, 21 [3.7%] were ulcerative, 108 [18.9%] were exophytic, and 30 [5.3%] were in the miscellaneous group. Overall, Fordyce granules [n = 116; 20.4%] were the most frequently detected condition. A significantly higher [p < 0.001] percentage of older patients [21-40 years and 41 years] had oral mucosal lesions than those in the

Weekly dose of Iron-folate supplementation with vitamin-C in the workplace can prevent anaemia in women employees

To assess if a weekly dose of iron and folic acid along with vitamin C, in the workplace would reduce the prevalence of anaemia. A multi-pronged intervention was carried out to reduce the prevalence of anaemia among workers of 7 apparel manufacturing factories using a regime consisting of a supervised single dose of albendazole [400mg] followed by a weekly dose of dried ferrous sulphate [150mg], folic acid [0.5mg] and vitamin C [100mg]. Workers were provided information on the causes of anaemia and its prevention. The total duration of the intervention was 16 weeks. Haemoglobin levels of a randomly selected sample of workers were tested before and after the intervention using a computerized non-cyan-meth-haemoglobin method. Of the 10810 workers who were enrolled a sample of 515 workers was randomly selected for the blood investigations. At the end of the intervention [18 weeks after the first blood sample was collected] only 361 out of the 515 who had been enrolled a little more than 16 weeks earlier still remained in the factories and among women 279 out of 385 enrolled were still working in the factories. In the 385 unmatched samples the number of anaemic women had reduced from 141 before the intervention to 79 after - mean haemoglobin increasing from 12.2 to 13.0 [p < 0.001] and in the 279 paired samples prevalence of anaemia had reduced from 105 to 58 - mean haemoglobin increasing from 12.1 to 13.0 [p < 0.001]. Our results demonstrated that in resource poor regions, where prevalence of anaemia is high, the workplace may be considered an ideal location to give a weekly supervised dose of iron, folic acid and vitamin C to effectively tackle the problem and probably improve worker efficiency

Prevalence of Candida dubliniensis among oral Candida isolates in patients attending the Kuwait University Dental Clinic

The aim of this study was to determine the oral candidal carriage of patients seeking dental treatment at the Kuwait University Dental Clinic and to ascertain the Candida species composition among them. 370 oral rinse samples were collected from patients. The germ tube test, CHROMagar Candida medium and VITEK 2 yeast identification system were used for species identification. C. dubliniensis isolates were confirmed by the production of rough colonies with hyphal fringes and chlamydospores on simplified sunflower seed agar. Of the 370 samples investigated, 160 [43.24%] showed Candida in culture. The isolation of Candida was significantly higher in individuals who were smokers or were under medication for either diabetics or asthma [99 [62%]] compared to healthy individuals [61 [38%]]. Of the 210 samples which did not yield Candida, 131 [62.38%] were healthy and 79 [37.62%] were associated with smoking or with usage of drugs for aforementioned conditions. Species isolated were C. albicans [102 [63.7%]], C. dubliniensis [23[14.3%]], C. krusei [13 [8.1%]], C. tropicalis [12 [7.5%]] and C. glabrata [10 [6.2%]].Candida species were more prevalent in patients having predisposing factors implicated in oral candidosis, such as in smokers, diabetic patients and asthmatic patients using inhalation steroids. C. albicans was the most prevalent species isolated, followed by C. dubliniensis

longitudinal study of the morbidity and nutritional status of workers employed in a garment factory

Given the health risks associated with the garment manufacturing industry, it is important to periodically evaluate the health status of these workers. Our objectives in this study were to firstly assess the change in morbidity profile by comparing the recorded ailments of workers in a garment factory in a three year period and secondly to assess the change in their nutritional status [Body Mass Index] over a period of three years. Retrospective cohort study design was used. Data from the periodic health check up for these employees in 2005 and 2002 was compared. Data was analyzed for 187 employees [males 19; female 168] who were present for the health check up of both 2005 and 2002. The chi-square test and comparison of change in percentages were used to determine significance of change in BMI. Musculoskeletal ailments were the most common health problems in the garment factory. There was an increase in the number of workers with complaints of dental caries, refractive errors and respiratory ailments. There was an increase in the proportions of pre-obese, obese [class 1] and obese [class 2] workers and a decrease in the proportion of those underweight and normal. Analysis showed a significant increase in the Body Mass Index [BMI] of workers who were previously underweight [p=0.00], normal [p<0.001] or pre-obese [p=0.03]. These findings, which are probably related to sedentary occupation, call for regular monitoring of BMI as well as dietary and lifestyle interventions for these workers. The findings also answer the call for factory-based interventions to improve workers' health

stitch in time ... Annual health appraisal of garment industry employees

The objectives of the study were to document the morbidity profile of the workers working in garment factories while treating them for the same and to document any likely occupational problems faced by the workers and suggest measures to improve work and health conditions. This study was conducted in 2003-2004 at eight garment factories employing more than 4000 workers. Data was obtained from the records of the annual medical check up that was provided for the workers of this industry. The records of the annual medical check up for 3858 were perused. The data was entered into Excel spreadsheet and analysed. The workforce consisted mainly of women in the 21-30 years age group, while males being more in the supervisory and mechanical cadres. None of them had undergone a periodic medical examination. Musculoskeletal problems were the commonest pre-existing morbidity reported by workers and the same problem was reported by most as being a probable occupational problem. Malnutrition at both ends of the spectrum was also detected. Hypertension was found in nearly 2.5% of the employees. An annual medical check up provided to the workers is likely to yield a large number and variety of morbidity as seen in our study. Our experience has shown that the support of the management of the factory is crucial to the success of such a large scale programme