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Background: In the present COVID-19 pandemic, social distancing measures have been advised to protect elderly from infection which might have led to poor mental health state. Objective: A cross-sectional study was carried out to assess the magnitude of social isolation, social support, and psychological distress among the elderly during the COVID-19 pandemic in Central India. Methods: The estimated sample size was 1535. The sample was equally distributed among rural, semiurban, and urban strata of districts. Social isolation was measured using Lubben’s Social Network Scale?Revised, and psychological distress was assessed using Kessler K10 Psychological Distress Scale. Other parameters such as a history of COVID-19 illness and COVID-19 vaccination were assessed. Results: The prevalence of social isolation was higher at 23.6% during the COVID?19 pandemic compared to before the pandemic period (15.0%). The majority perceived a high level of social support during the pandemic (55.3%) and 39.9% received moderate support. Overall, 18.4% of the respondents had psychological distress. Out of them, 56.2% had mild distress, 20.1% had moderate distress, and 23.7% had severe distress. Significant predictors of psychological distress were female gender, lower socioeconomic status, history of COVID-19 disease among the participants, social isolation, and lack of social support. Conclusion: Social isolation and lack of social support were significant predictors of psychological distress among the elderly during the pandemic.
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Background: Standardized instruments are needed for rigorous research, quality clinical practice and informed policy-making. In Mongolia, a confluence of current social, demographic and geographic factors augment the need for reliable means to assess social isolation among older adults. This study aims to identify, translate and validate such a measure. Method: We conducted the study in two phases. We first selected the 18-item Lubben Social Network Scale and followed Brislin’s 6-step model to translate the instrument from English to Mongolian. The second phase involved psychometric testing of the Mongolian version (LSNS-18-M). We recruited 198 Mongolians aged ≥ 55 years from six hospitals in Ulaanbaatar. All participants also completed the SF-12; the 15-item Geriatric Depression Scale; and measures of objective and subjective Social Isolation’ of these, 27 completed a re-test of the LSNS-18-M.Results: The LSNS-18-M showed strong psychometric properties. Cronbach alpha coefficients were high for the overall scale (0.89) and for family (0.85), friend (0.91) and neighbor (0.89) subscales. Infraclass correlation coefficients for the total scale (0.99) and family (0.99), friend (0.98) and neighbor (0.99) subscales were also high in the test-retest subsample. With respect to convergent validity, LSNS-18-M scores were inversely related to Social Disconnectedness (r=-0.55, p<0.001)and Perceived Isolation (r=-0.65, p<0.001) and with the GDS-15 (r=-0.31, p<0.001). Although not related to either subscale of the SF-12, the LSNS-M-18 was inversely associated with self-rated health status (r=-0.27, p<0.01). Mean LSNS-18-M scores successfully differentiated three levels of Social Disconnectedness and three levels of Perceived Isolation, indicating good discriminate validity.Finally, content validity was good. Items on the LSNS-18-M loaded cleanly on the same three factors as the original LSNS-18. Inter-factor correlations ranged from 0.23 to 0.77, all three factors correlated with total LSNS-18-M scores at p<0.001, and together they accounted for the majority of variance in total LSNS-18 scores.Conclusion: The LSNS-18-M has excellent reliability and satisfactory validity and holds significant promise for assessing social isolation among older adults in Mongolia.
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Objectives: Stress in medical students is well established. It may affect academic performance and lead to anxiety, depression, substance abuse, and burnouts. There is limited data on stress in Indian medical students. We conducted an analytical observational study to assess the magnitude of stress and identify possible "stressors" in medical students of a teaching hospital in Kolkata. Materials And Methods: This questionnaire-based study was conducted in the Institute of Post Graduate Medical Education and Research, Kolkata with consenting undergraduate students of 3 rd , 6 th , and 9 th (final) semesters, during lecture classes in individual semesters on a particular day. The students were not informed about the session beforehand and were assured of confidentiality. The first part of the questionnaire captured personal and interpersonal details which could be sources of stress. The rest comprised three rating scales - the 28-item General Health Questionnaire to identify the existence of stress, the Warwick-Edinburgh mental well-being scale to assess the mental well-being, and the revised version of the Lubben social network scale to assess the social networking. The responses and scores were compared between the three semesters as well as between various subgroups based on baseline characteristics. Results: Data from 215 respondents were analyzed - approximately 75% were male, 45% came from rural background, 25% from low-income families, and 60% from vernacular medium. Totally, 113 (52.56%; 95% confidence interval: 43.35-61.76%) students were found to be stressed, without significant difference in stress incidence between the semesters. About 60% of the female students were stressed in contrast to 50% of the males, but this observed difference was not statistically significant. The mental well-being and social networking of stressed respondents suffered in comparison to their non-stressed counterparts. Conclusions: The stress incidence in medical students in this institution in India is high and is negatively affecting their mental well-being. Further multicentric and longitudinal studies are needed to explore the incidence, causes, and consequences of stress in our setting.